全程护理干预改善药物临床试验中受试儿童依从性的研究

目的探讨在药物临床试验中给予受试儿童全程护理干预对期依从性的影响。方法便利选取2021年3月—2022年6月在厦门大学附属妇女儿童医院参加药物临床试验的受试儿童86例为研究对象,按照随机数表法分为干预组(n=43)与对照组(n=43),对照组采用常规护理干预,干预组采用全程护理干预,对两组依从性、不良事件发生情况及护理满意度进行比较。结果干预组总依从率为95.35%,高于对照组的81.40%,差异有统计学意义(χ^(2)=4.074,P<0.05);干预组不良事件总发生率为6.98%,低于对照组的23.26%,差异有统计学意义(χ^(2)=4.441,P<0.05);干预后,两组NSNS评分均高于干预前,且干预组高于对照组,差异有统计学意义(P<0.05)。结论全程护理干预应用于药物临床试验中,能够增强受试儿童依从性,降低不良事件发生率,提高护理满意度。

小儿过敏性紫癜急性期外周血CD4^+、CD8^+T细胞及免疫球蛋白的变化及意义

目的分析小儿过敏性紫癜(HSP)急性期外周血CD4^+、CD8^+T细胞、免疫球蛋白水平情况。方法选取我院小儿过敏性紫癜急性期患儿80例为观察组,选择同期我院健康体检的儿童80例为对照组。比较两组CD4^+、CD8^+T细胞构成比,免疫球蛋白(IgA、IgM、IgG、IgE)水平。观察组患儿按照HSP的临床类型统计外周血CD4^+、CD8^+T细胞及免疫球蛋白结果,并比较不同类型患儿间上述指标差异。结果(1)观察组血清CD4^+、CD4^+/CD8^+低于对照组,CD8^+T高于对照组(均P<0.05)。(2)观察组IgA高于对照组(P<0.05)两组IgM、IgG、IgE比较差异无统计学意义(P>0.05)。(3)观察组不同类型HSP患儿外周血T淋巴细胞亚群及免疫球蛋白水平比较差异均无统计学意义(P>0.05)。结论小儿过敏性紫癜急性期外周血CD4^+、CD8^+T细胞及免疫球蛋白(IgA)水平降低可能与患儿免疫功能下降有关,对HSP患儿的诊断和治疗具有一定临床价值。

Changes of ghrelin following oral glucose tolerance test in obese children with insulin resistance

AIM： To characterize changes in ghrelin levels in response to oral glucose tolerance test （OGTT） and to correlate changes in ghrelin levels with changes in insulin and glucose following OGTT in Chinese obese children of Tanner Ⅰ and Ⅱ stage with insulin resistance. METHODS： 22 obese children with insulin resistance state were divided into four groups according to their Tanner stage and gender： boys of Tanner Ⅰ （fir- Ⅰ ）, boys of Tanner Ⅱ（BT-Ⅱ ）, girls of Tanner Ⅰ （GT- Ⅰ ）, girls of Tanner Ⅱ （GT-Ⅱ）. Ghrelin, insulin and glucose were measured at 0, 30, 60 and 120 rain following OGTT. The control children with normal BMI were divided into control boys of Tanner Ⅰ （CBT- Ⅰ, n = 6）, control boys of Tanner Ⅱ （CBT-Ⅱ, n = 5）, control girls of Tanner Ⅰ （CGT- Ⅰ, n = 6）, control girls of Tanner Ⅱ （CGT-Ⅱ, n = 5）. Fasting serum ghrelin levels were analyzed. RESULTS： Ghrelin levels were lower in obese groups. Ghrelin levels of control group decreased in Tanner Ⅱ stage （CGT- Ⅰ vs CGT-Ⅱ t = -4.703, P = 0.001; CBT- Ⅰ vs CBT- Ⅱ t = -4.794, P = 0.001）. Basal ghrelin levels in fir-Ⅱ decreased more significantly than that in BT- Ⅰ group （t = 2.547, P = 0.029）. Ghrelin levels expressed a downward trend after OGTT among obese children. The decrease in ghrelin levels at 60 min with respect to basal values was 56.9% in BT- Ⅰ. Ghrelin concentrations at 0 min correlated directly with glucose level at 0 min in fir- Ⅰ （r = 0.898, P = 0.015）. There wasn＇t a significant correlation of ghrelin changes with glucose changes and insulin changes during OGTT in obese children with insulin resistance. CONCLUSION： In conclusion, in obese children with insulin resistance, ghrelin levels decreased with advancing pubertal stage. Ghrelin secretion suppression following OGTT was influenced by gender and pubertal stage. Baseline ghrelin levels and ghrelin suppression after OGTT did not significantly correlate with the degree of insulin resistance and insulin sensitivity.