Meta-analysis of the comparison between reduning injection and ribavirin injection for acute upper respiratory tract infection in children

Objective:To systematically evaluate the effectiveness and safety of reduning injection in acute upper respiratory tract infection of children.Methods:Use computer to search PubMed,the Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,Weipu database(VIP)and China Biomedical studies Service System(CBM)for randomized controlled trials(RCT)of acute upper respiratory tract infection in children,and the retrieval time is from their establishment to May,2022.After two researchers independently screened the studies,extracted data and evaluated the risk bias of studies,RevMan5.3 software was used to perform meta-analysis.Results:10 studies in total were included,involving 1466 patients.Results of the meta-analysis:total effective rate[RR=1.12,95%CI(1.07,1.16),P<0.00001],cure time[MD=-1.51,95%CI(-1.71,-1.32),P<0.00001],antipyretic time[MD=-1.32,95%CI(-1.72,-0.92),P<0.00001],disappearing time of nasal obstruction and nose running[MD=-1.04,95%CI(-1.45,-0.62),P<0.00001],disappearing time of cough[MD=-1.35,95%CI(-1.58,-1.13),P<0.00001],disappearing time of throat congestion[MD=-1.36,95%CI(-1.68,-1.03),P<0.00001],disappearing time of sore throat[MD=-1.55,95%CI(-1.74,-1.35),P<0.00001],the incidence of adverse reactions[RR=0.34,95%CI(0.20,0.57),P<0.0001].The differences between two groups in total effective rate,cure time,antipyretic time,disappearing time of nasal obstruction and nose running,disappearing time of cough,disappearing time of throat congestion,disappearing time of sore throat and the incidence of adverse reactions are all statistically significant(P<0.05).The sensitivity analysis demonstrates that three outcomes(total effective rate,cure time and disappearing time of sore throat)have unstable results,while others having stable results.Conclusion:Reduning injection is more effective than ribavirin injection in clinical,and it is better than ribavirin injection at relieving fever,nasal obstruction and nose running,cough and throat congestion.In addition,it’s safer in clinical than ribavirin injection.

The Effect of Comfort Nursing on the Compliance and Efficacy of Treatment for Children with Acute Otitis Media Caused by Upper Respiratory Tract Infection

Objective:To explore and analyze the clinical effect of comfort nursing on children with acute otitis media.Methods:62 children with acute otitis media caused by upper respiratory tract infection who visited the outpatient clinic of our hospital from June 2022 to June 2023 were selected for this study.They were divided into a study group(n=31)and a control group(n=31).Children in the control group received basic care,while children in the study group received comfort nursing along with basic care.The hearing thresholds,body temperature,treatment compliance,and nursing satisfaction of the two groups of children were compared.Results:After the nursing intervention,the hearing threshold and average body temperature of the children in the study group were lower than those in the control group(P<0.05);the treatment compliance of the children in the study group was higher than that in the control group(P<0.05);the nursing satisfaction of the study group was higher than that of the control group(P<0.05).Conclusion:Comfort nursing can improve the treatment effect,treatment compliance,and nursing satisfaction of children with children with acute otitis media caused by upper respiratory tract infection.

Prescription practice of antihistamines for acute upper respiratory tract infections in pediatric patients in a local emergency department in Hong Kong

BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.

Qingkailing injection for the treatment of acute upper respiratory infection in children: a systematic review and meta-analysis

Objective:To systematically evaluate the clinical efficacy and safety of Qingkailing (QKL) injection for pediatric acute upper respiratory infection (AURI).Methods:We searched for randomized controlled trials (RCTs) of pediatric AURI treated by QKL and western medicine (WM) in the China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang,Chinese Biomedical Literature Database,PubMed and Cochrane Library from inception to August,2016.Two reviewers independently retrieved the RCTs and extracted information.The Cochrane Collaboration Risk of Bias Assessment Tool was used to evaluate the methodological quality of RCTs.The data were meta-analyzed by RevMan 5.3 software.Results:Ultimately,21 RCTs that involved 2364 participants were included,and the quality of RCTs was generally poor.According to the meta-analysis,the combined use of QKL and WM for treating AURI can be effective,with a higher total effective rate,less defervescence time and less recovery time of tonsil and throat inflammation.Twenty-five adverse drug reactions (ADRs) were reported in three RCTs,but there were no serious ADRs.Conclusion:The combination of QKL and WM for treating pediatric AURI can result in better effects,but no definitive conclusions can be made regarding its safety.More rigorous RCTs are needed to support the clinical application of QKL.

Effectiveness and Safety of Jinye Baidu Granules(金叶败毒颗粒)for Acute Upper Respiratory Tract Infection:A Systematic Review and Meta-analysis

To evaluate the effectiveness and safety of Jinye Baidu Granules(金叶败毒颗粒)for acute upper respiratory tract infection(AURTI).Database such as CNKI,Wan-fang,VIP,Sino Med,Web of science,Clinical Trials gov,Medline、EMBASE,CENTRAL,Cochrane Library were retrieved to collect randomized controlled trials(RCTs)on Jinye Baidu Granules(金叶败毒颗粒)in treating AURTI from the estabslishment of the database to March 2019.A total of 2 reviewers independently screened the literature according to the inclusion and exclusion criteria,and extracted material and the quality evaluation of the included studies.Quality evaluation adopted Cochrane Handbook 5.1 evaluation standards and tools.Rev Man5.3 was used to perform Meta-analysis for the adopted study.Finally a total of 4 RCTs involving 636 patients were included.Meta-analysis results showed that:compared with conventional Western medicine alone,Jinye Baidu Granules(金叶败毒颗粒)combined with Western medicine in the treatment of acute upper respiratory tract infection can improve the total effective rate of clinical efficacy[RR=0.13,95%CI(0.06,0.29),P<0.00001],shorten the time of antipyretic time for acute upper respiratory tract infection[MD=–1.22,95%CI(–1.43,–1.00),P<0.00001],shorten the time of pharyngeal pain[MD=–1.97,95%CI(–2.97,–0.96),P<0.0001]and shorten the cough disappear time[MD=–1.97,95%CI(–2.97,–0.96),P<0.0001].There were 2 papers reporting adverse reactions during the study period,and one of them specifically reported diarrhea,nausea,vomiting and stomachache in the experimental group.In the control group:diarrhea,nausea and adverse reactions disappeared after drug withdrawal;the incidence of adverse reactions was 3.92%in the control group and 5.88%in the observation group.There was no significant difference between the 2 groups(P>0.05).Based on existing data and methods,the systematic evaluation showed that,compared with Western medicine alone,Jinye Baidu Granules(金叶败毒颗粒)combined with Western medicine alone could improve the total effective rate of clinical efficacy,reduce the time of fever,sore throat,and the disappearance of cough with less adverse reactions.However,due to the low quality of the included study,large samples,multicenter,randomized,double-blind trials and trials are still needed to randomized controlled trials with reference to the CONSORT standard and the STRICTA statement.

Effect of secretory IgA combined with conventional anti-infectious drugs on inflammatory response and immune response in children with upper respiratory tract infection

Objective: To investigate the effect of secretory IgA combined with conventional anti-infectious drugs on inflammatory response and immune response in children with upper respiratory tract infection. Methods: A total of 130 children with upper respiratory tract infection who were treated in the hospital between February 2016 and February 2017 were divided into control group and secretory IgA group by random number table method, each group with 65 cases. Control group received routine anti-infectious drug treatment, and secretory IgA group received the secretory IgA combined with conventional anti-infectious drug treatment, which lasted for 1 week. The differences in serum levels of routine inflammatory factors, fat inflammatory factors and immunoglobulin were compared between the two groups before and after treatment. Results: There was no statistically significant difference in serum levels of normal inflammatory factors, fat inflammatory factors and immunoglobulin between the two groups before treatment. After 1 week of treatment, serum conventional inflammatory factors CRP, IL-1 and IL-8 levels of secretory IgA group were lower than those of control group;serum fat inflammatory factors SAA and Chemerin levels were lower than those of control group whereas Leptin level was higher than that of control group;serum immunoglobulin IgA, IgG and IgM contents were higher than those of control group. Conclusion: The secretory IgA combined with conventional anti-infectious drugs can effectively inhibit the systemic inflammatory response and enhance the humoral immune response in children with upper respiratory tract infection.

ACUPUNCTURE TREATMENT OF 42 CASES OF ACUTE UPPER RESPIRATORY TRACT INFECTION

We made clinical observations on the therapeutic effect of acupuncture on acute upper respiratory tract infection and compared with the effect of paracetamol and Antondine, The result showed that acupuncture therapy could allay fever more rapidly than drugs, so long as the differentiation of syndromes is correct and the acupoint is selected properly.

Clinical Diagnosis and Treatment Characteristics of Acute Respiratory Infections in Children and New Developments in Laboratory Testing

Acute respiratory tract infection (ARTI) in children is the most common infectious disease in childhood, and its pathogens include viruses, bacteria and fungi, mycoplasma, chlamydia and rickettsia. In recent years, with the continuous development of pathogen detection methods, the diagnosis and treatment of acute respiratory infections has received more and more clinical attention. The clinical diagnosis and treatment characteristics of acute respiratory infections in children and the research of clinical laboratory detection methods have also been continuously developed. The author collected references to review the clinical features and new developments in laboratory testing of acute respiratory tract infection in children.

Clinical practices s of Traditional Chinese Medicine for acute upper respiratory tract infection in children

OBJECTIVE:To develop Clinical practice s of Traditional Chinese Medicine(TCM) for acute upper respiratory tract infection(AURI) in children;TCM is usedalone or administered together with antibiotics.METHODS:Under the guidance of evidence-based medicine concept,in strict accordance with the rules of international s development,as well as on the basis of evidence of clinical research of TCM,the s solicited opinions from clinical experts and methodologists in TCM and Western Medicine.GRADE standard was applied to form experts' consensus.RESULTS:The s standardized classification of TCM patterns and TCM treatments in children with AURI,including prescription,Chinese patent medicine,non-drug treatment and prevention.CONCLUSION:Follows the principle of "evidence based,consensus supplemented,and experience referred",these s were formulated,but the quality of evidence of included studies were relatively low.Further refinement of the s should be needed as deeper clinical studies as available in future.

Acute lobar nephritis in children: Not so easy to recognize and manage

Acute lobar nephritis(ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.

Human adenovirus(HAdV)infection in children with acute respiratory tract infections in Guangzhou,China,2010–2021:a molecular epidemiology study

Background Human adenovirus(HAdV)infection can cause a variety of diseases.It is a major pathogen of pediatric acute respiratory tract infections(ARIs)and can be life-threatening in younger children.We described the epidemiology and subtypes shifting of HAdV among children with ARI in Guangzhou,China.Methods We conducted a retrospective study of 161,079 children diagnosed with acute respiratory illness at the Guangzhou Women and Children’s Medical Center between 2010 and 2021.HAdV specimens were detected by real-time PCR and the hexon gene was used for phylogenetic analysis.Results Before the COVID-19 outbreak in Guangzhou,the annual frequency of adenovirus infection detected during this period ranged from 3.92%to 13.58%,with an epidemic peak every four to fve years.HAdV demonstrated a clear seasonal distribution,with the lowest positivity in March and peaking during summer(July or August)every year.A signifcant increase in HAdV cases was recorded for 2018 and 2019,which coincided with a shift in the dominant HAdV subtype from HAdV-3 to HAdV-7.The latter was associated with a more severe disease compared to HAdV-3.The average mortality proportion for children infected with HAdV from 2016 to 2019 was 0.38%but increased to 20%in severe cases.After COVID-19 emerged,HAdV cases dropped to 2.68%,suggesting that non-pharmaceutical interventions probably reduced the transmission of HAdV in the community.Conclusion Our study provides the foundation for the understanding of the epidemiology of HAdV and its associated risks in children in Southern China.

宣肺运脾方辅助西药治疗儿童哮喘并发反复呼吸道感染临床研究

目的:探究宣肺运脾方辅助西药治疗哮喘并反复呼吸道感染儿童的临床价值。方法:将110例哮喘并发反复呼吸道感染患儿按抽签法分为西医组55例,使用西药治疗;中西医结合组55例,使用宣肺运脾方加西药治疗。比较两组疗效指标、炎症因子、免疫功能及药物不良反应发生情况。结果:两组疗效指标、炎症因子、免疫功能比较差异均有统计学意义(P<0.05),中西医结合组治疗总有效率更高,呼吸道感染及哮喘发作次数、发热及咳嗽持续时间均更少(P<0.05),干扰素γ(IFN-γ)、辅助性T细胞CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)更高(P<0.05),白细胞介素13(IL-13)、基质金属蛋白酶9(MMP-9)、CD8^(+)更低(P<0.05);两组药物不良反应发生情况差异无统计学意义(P>0.05)。结论:西药联合宣肺运脾方治疗哮喘并反复呼吸道感染儿童可提高疗效,抑制炎症反应,改善免疫功能。

华西广医1号急性毒性、鼻黏膜刺激性和增强免疫功能的研究

为初步了解拟开发医院雾化制剂华西广医1号的安全性和有效性,通过小鼠急性毒性试验、大鼠鼻黏膜刺激性试验和增强免疫功能的药效学试验方法研究了华西广医1号安全性和药效。结果表明:以0.34 g/mL药液24 h内雾化给药,对小鼠无明显急性毒性;对大鼠经鼻腔给药无明显刺激性;以0.068 g/mL雾化给药,有升高幼龄小鼠的胸腺指数的作用趋势;可升高环磷酰胺致免疫功能低下小鼠的巨噬细胞碳粒廓清指数K、校正指数α和外周血白细胞数目(white blood cell,WBC),红细胞数目(red blood cell,RBC)和血红蛋白浓度(hemoglobin,HGB)水平,并可升高溶血素值。可见,华西广医1号雾化给药小鼠的最大给药量为34 g/kg,无明显鼻黏膜刺激性,0.068 g/mL雾化给药有增强免疫功能,可用于预防上呼吸道感染。

血清LBP、CXCL-10对小儿急性上呼吸道细菌感染的鉴别诊断价值及其影响因素

目的探讨血清脂多糖结合蛋白(LBP)、血清CXC趋化因子配体-10(CXCL-10)对小儿急性上呼吸道细菌感染的鉴别诊断价值及其影响因素。方法将2021年7月至2022年6月该院收治的90例急性上呼吸道感染患儿纳入研究作为研究组。另选取同期于本院进行体检40例健康儿童作为健康组。根据痰液细菌培养结果将研究组患儿分为细菌感染组(51例)和非细菌感染组(39例)。采用酶联免疫吸附法检测血清LBP、CXCL-10水平。采用受试者工作特征(ROC)曲线评估血清LBP、CXCL-10对小儿急性上呼吸道细菌感染的鉴别诊断价值。采用多因素Logistic回归分析小儿急性上呼吸道细菌感染的影响因素。结果研究组血清LBP、CXCL-10水平高于健康组(P<0.05)。细菌感染组血清LBP、CXCL-10水平高于非细菌感染组(P<0.05)。血清LBP、CXCL-10单独及联合用于诊断小儿急性上呼吸道细菌感染的曲线下面积(AUC)分别为0.779(95%CI:0.724~0.822)、0.843(95%CI:0.796~0.898)、0.906(95%CI:0.852~0.959)。细菌感染组家庭成员吸烟、铁元素缺乏、钙元素缺乏者所占比例、年均抗菌药使用次数、血清LBP、CXCL-10水平均高于非细菌感染患者(P<0.05)。Logistic多因素回归分析显示,年均抗菌药使用次数≥2次(OR=2.305,95%CI:1.483~3.582)、LBP≥104.26 ng/mL(OR=2.573,95%CI:1.446~4.578)、CXCL-10≥112.98 pg/mL(OR=1.208,95%CI:0.110~1.314)是小儿急性上呼吸道细菌感染的影响因素(P<0.05)。结论血清LBP、CXCL-10水平升高与儿童急性上呼吸道细菌感染密切相关,可作为鉴别诊断急性上呼吸道细菌感染的指标且二者联合诊断的效能更高。

儿童急性呼吸道感染者PA、PSP、CD64、sCD14-ST的变化及其诊断价值

目的 探讨儿童急性呼吸道感染者血前白蛋白(PA)、血清胰石蛋白(PSP)、免疫球蛋白G Fc段受体I(CD64)、可溶性白细胞分化抗原14亚型(sCD14-ST)的变化及其临床诊断价值。方法 回顾性选取2019年9月至2023年3月眉山市四所医院收治的498例儿童急性呼吸道感染患儿作为研究组,根据咽拭子细菌培养结果将其分为细菌感染组232例和非细菌感染组266例;另选取同期体检的健康儿童506例作为对照组。检测所有儿童的血清PA、PSP、外周血sCD14-ST水平、CD64指数。比较三组儿童的临床资料,同时比较研究组和对照组以及细菌感染组和非细菌感染组患儿的血清PA、PSP、外周血sCD14-ST水平、CD64指数;采用受试者工作特征曲线(ROC)分析血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测对儿童急性呼吸道感染的诊断价值。结果 研究组患儿的血清PA水平明显低于对照组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于对照组,差异均有统计学意义(P<0.05);细菌感染组患儿的血清PA水平明显低于非细菌感染组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于非细菌感染组,差异均有统计学意义(P<0.05);绘制ROC获得血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测诊断儿童急性呼吸道感染患儿的AUC分别为0.885、0.780、0.818、0.848、0.934。其中,联合诊断的AUC高于各项单独检测(P<0.05),且联合检测的敏感度和特异度为89.20%,81.40%,诊断价值均较高。结论 儿童急性呼吸道感染者血清PA水平呈低表达,血清PSP、外周血sCD14-ST水平、CD64指数呈高表达;且细菌感染较非细菌感染的儿童急性呼吸道感染患儿血清PA水平降低,而血清PSP、外周血sCD14-ST水平和CD64指数则升高;联合检测血清PA、PSP、外周血sCD14-ST水平、CD64指数有助于诊断儿童急性呼吸道感染。

百蕊颗粒治疗儿童急性上呼吸道感染疗效及安全性系统评价

目的系统评价百蕊颗粒治疗儿童急性上呼吸道感染(AURTI)的疗效及安全性。方法通过计算机系统检索中国知网、万方数据与维普网数据库自建库至2022年9月有关百蕊颗粒治疗儿童AURTI的随机对照研究,并按照Cochrane质量评价标准对纳入研究的方法学质量进行评估,运用RevMan 5.4软件进行Meta分析。结果纳入文献10篇,涉及患儿1257例。Meta分析显示百蕊颗粒组总有效率高于对照组(OR=4.26,95%CI:2.94~6.16,P<0.00001)。依据疾病类型、治疗疗程进行亚组分析,结果显示,疱疹性咽峡炎患者与非疱疹性咽峡炎患者百蕊颗粒组总有效率均高于对照组(OR=5.34,95%CI:3.23~8.84,P<0.00001;OR=3.12,95%CI:1.80~5.42,P<0.0001);疗程3~5 d与6~7 d百蕊颗粒组总有效率均高于对照组(OR=5.24,95%CI:3.20~8.59,P<0.00001;OR=3.14,95%CI:1.79~5.52,P<0.0001)。百蕊颗粒组退热时间、咽喉部症状消退时间短于对照组(MD=-1.23,95%CI:-1.78~-0.68,P<0.0001;MD=-1.38,95%CI:-1.65~-1.11,P<0.00001)。百蕊颗粒组与对照组不良反应总发生率比较差异无统计学意义(OR=2.09,95%CI:0.69~6.33,P=0.19)。结论百蕊颗粒治疗儿童AURTI疗效较好,且不会增加不良反应。

古代医籍对于小儿急性上呼吸道感染的认识

急性上呼吸道感染是现代临床上的常见病、多发病。与成人患病有所不同,小儿由于特殊的生理特征而更易发生急性上呼吸道感染,且多存在患病后夹杂兼证的情况。从中医医史的角度系统研究小儿急性上呼吸道传染病,探讨古代医籍对小儿急性上呼吸道感染认识的历史沿革,有利于对该病作出深入认识和鉴别诊断。本研究总体上以纵向历史时代为序,通过列举大量中医古籍中的具体实例,系统梳理了历代中医古籍中对该病病名范畴、病因病机、小儿生理与发病以及兼挟证等方面的记载,并相应地进行特点探析和分析总结,从古代医籍的角度总结各个历史阶段对该病关键特征的认识,以期为现代临床正确认识、鉴别和诊治该病提供充分的理论依据与辨证思路。

万应胶囊联合布洛芬治疗儿童急性上呼吸道感染中高热的效果

目的评价万应胶囊联合布洛芬治疗儿童急性上呼吸道感染(上感)中高热的效果和安全性。方法选取72例上感中高热的门诊患儿为研究对象,按随机数字表法分为观察组和对照组,对照组36例,给予布洛芬(按需)治疗:观察组36例,给予万应胶囊+布洛芬(按需)治疗。2组患儿均治疗3 d,治疗期间患儿痊愈可随时停药。比较2组患儿疗效(愈显率),治疗前后血淋巴细胞和C-反应蛋白(CRP)水平的变化,退热起效时间和完全退热时间,布洛芬日平均用药量和次数,以及不良事件(腹泻、腹痛、胃部不适、呕吐、反酸、嗳气、皮疹、头晕、头痛、胸闷等)的发生情况。结果观察组治疗愈显率高于对照组(80.56%比44.45%,P<0.01);治疗后2组患儿血淋巴细胞和CRP水平均较治疗前降低(均P<0.05);观察组患儿治疗后血淋巴细胞和CRP水平均低于对照组(均P<0.05);观察组退热起效时间和完全退热时间均短于对照组,布洛芬日平均用药量和用药次数均少于对照组(均P<0.05);2组均未报告不良事件的发生。结论万应胶囊联合布洛芬治疗儿童上感中高热的疗效显著,退热起效快,可缩短病程,减轻炎症反应,安全性好。

血清MyD88和TRAF-6联合检测在儿童重度急性呼吸道感染诊断和预后评估中的价值

目的探讨血清髓系分化初级反应蛋白88(MyD88)、肿瘤坏死因子受体相关因子6(TRAF-6)在儿童重度急性呼吸道感染辅助诊断和预后评估中的价值。方法选取2020年1月—2022年6月南阳市中心医院儿童急性呼吸道感染患儿80例(急性呼吸道感染组)。根据病原学检测结果分为非细菌感染组(42例)和细菌感染组(38例)。根据患儿病情严重程度分为轻度组(28例)、中度组(20例)、重度组(32例)。根据患儿预后情况分为预后良好组(58例)和预后不良组(22例)。以同期80名体检健康儿童为正常对照组。采用多因素Logistic回归分析评估急性呼吸道感染患儿预后的影响因素。采用受试者工作特征(ROC)曲线评价各项指标诊断儿童重度急性呼吸道感染和评估预后的效能。结果急性呼吸道感染组血清MyD88、TRAF-6水平显著高于正常对照组(P<0.001)。细菌感染组血清MyD88、TRAF-6水平显著高于非细菌感染组(P<0.001)。轻度组、中度组、重度组血清MyD88、TRAF-6水平依次升高(P<0.001)。ROC曲线分析结果显示,血清MyD88、TRAF-6单项检测和联合检测诊断重度急性呼吸道感染的曲线下面积(AUC)分别为0.762、0.734、0.876。预后不良组细菌感染、下呼吸道感染、重度病情所占比例和白细胞(WBC)计数、反应蛋白(CRP)、MyD88、TRAF-6水平均显著高于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,重度病情、CRP升高、MyD88升高、TRAF-6升高均是儿童急性呼吸道感染预后不良的危险因素[比值比(OR)值分别为1.693、1.864、3.218、2.869,95%可信区间(CI)分别为1.142~2.510、1.228~2.830、1.561~6.633、1.511~5.446,P<0.05]。ROC曲线分析结果显示,血清MyD88、TRAF-6、CRP单项检测和联合检测判断急性呼吸道感染患儿预后的AUC分别为0.848、0.900、0.817、0.951。结论急性呼吸道感染患儿血清MyD88、TRAF-6水平显著升高,联合检测对儿童重度急性呼吸道感染的辅助诊断和预后评估均有较高的临床价值。

炎宁糖浆联合干扰素治疗对急性上呼吸道感染患儿炎症和症状恢复的影响

目的:观察炎宁糖浆联合干扰素治疗对急性上呼吸道感染患儿炎症和症状恢复的影响。方法:选取华中科技大学协和江北医院2021年12月—2023年12月收治的120例急性上呼吸道感染患儿作为研究对象,按照随机数表法分为研究组和对照组,每组各60例。对照组采用干扰素治疗,研究组在对照组基础上联用炎宁糖浆,比较两种方案的临床疗效。结果:研究组治疗总有效率和CD3^(+)、CD4^(+)水平高于对照组,中医证候积分、CD8^(+)、白细胞计数(WBC)、中性粒细胞、C反应蛋白(CRP)水平低于对照组,止咳时间、鼻塞缓解时间和退热时间短于对照组,差异有统计学意义(P<0.05)。结论:炎宁糖浆联合干扰素治疗急性上呼吸道感染效果较好,能够显著缓解患儿临床症状,减轻呼吸道炎症刺激,提高其免疫功能,治疗实用性更高。