甘利欣联合阿奇霉素治疗支原体肺炎伴肝功能损害患儿的效果及对血清炎症因子、KL-6及NF-κB水平的影响  

Effect of Diammonium Glycyrrhizinate combined with Azithromycin in the Treatment of Mycoplasma Pneumonia with Liver Function Damage and Influence on Levels of Serum Inflammation, KL-6 and NF-κB in Children

作　　者：杜赢 牛焕红[2] 温慧 付小宁 曹林昌 

机构地区：[1]西安市长安医院儿科,陕西西安710018 [2]第四军医大学西京医院儿科,陕西西安710032

出　　处：《现代生物医学进展》2016年第32期6348-6352,共5页Progress in Modern Biomedicine

摘　　要：目的:探讨甘利欣联合阿奇霉素治疗对支原体肺炎伴急性肝功能损害患儿血清炎症因子、Ⅱ型肺泡表面抗原-6(KL-6)及核因子-κB(NF-κB)水平的影响。方法:选取86例支原体肺炎伴急性肝功能损害患儿为受试对象,随机数字表法分成研究组和对照组各43例。对照组中途脱落1例,共42例有效病例入组,予以常规对症治疗+阿奇霉素疗法;研究组中途脱落3例,共40例有效病例入组,在对照组治疗基础上联合甘利欣静脉滴注疗法。观察对比两组受试患儿治疗前后血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-12(IL-12)及肿瘤坏死因子-α(TNF-α)]、血清KL-6、血清NF-κB、肝功能指标[血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]变化情况,记录其发热、咳嗽、肺部湿罗音等消失时间差异。结果:治疗4w后,两组患儿IL-6[(44.5±6.2)pg/m L vs(60.3±6.6)pg/m L]、IL-12[(42.4±6.2)pg/m L vs(52.1±6.8)pg/m L]、TNF-α[(128.6±44.8)ng/L vs(201.4±51.8)ng/L]等血清炎症因子检测结果、ALT[(46.8±9.5)U/I vs(83.6±9.8)U/I]、AST[(62.2±10.1)U/I vs(84.8±10.2)U/I]、TBIL[(38.2±8.5)μmol/L vs(49.3±9.0)μmol/L]等肝功能指标检测结果及血清KL-6[(5.9±0.6)pg/m L vs(6.5±0.7)pg/m L]、NF-κB[(7.8±0.4)pg/m L vs(8.1±0.3)pg/m L]水平均较治疗前显著降低,且研究组小于对照组,差异有统计学意义(P<0.05)。研究组患儿治疗后发热、咳嗽、肺部湿罗音等消失时间均显著短于对照组患儿,差异有统计学意义(P<0.05)。结论:甘利欣联合阿奇霉素疗法可在促进支原体肺炎伴急性肝功能损害患儿病情转归、改善其血清炎症因子、调节肺功能、肝功能状态等方面发挥积极作用。Objective： To explore the effect of Diammonium Glycyrrhizinate combined with azithromycin in the treatment of mycoplasma pneumonia with liver function damage and influence on levels of serum inflammation, KL-6 and NF-κB in children.Methods： Eighty-six cases of children with mycoplasma pneumonia complicated with acute liver function damage were selected as subjects. According to the random number table method, they were divided into study group and control group, 43 cases in each. There was 1 case lost to follow up in the control group and 42 cases enrolled. The control group was treated with routine symptomatic treatment and azithromycin. There were 3 cases lost to follow up in study group and a total of 40 cases enrolled. On the basis of control group, the study group was treated with intravenous infusion of Diammonium Glycyrrhizinate. The changes of serum inflammatory factors[interleukin-6（IL-6）, interleukin-12（IL-12）, tumor necrosis factor alpha（TNF-α）], serum KL-6, serum NF-κB and liver function indexes[serum alanine aminotransferase（ALT）, aspartate amino transferase（AST）, total bilirubin（TBIL）] in the two groups before and after treatment were observed and compared. The differences in extinction time of fever, cough and lung wet rales, etc. were recorded. Results：After 4 weeks of treatment, the detection results of serum inflammatory factors such as IL-6 [（44.5±6.2）pg/m L vs（60.3±6.6）pg/m L],IL-12 [（42.4±6.2）pg/m L vs（52.1±6.8）pg/m L] and TNF-α [（128.6±44.8）ng/L vs（201.4±51.8）ng/L], liver function indexes such as ALT [（46.8±9.5）U/I vs（83.6±9.8）U/I], AST [（62.2±10.1）U/I vs（84.8±10.2）U/I] and TBIL [（38.2±8.5）μmol/L vs（49.3±9.0）μmol/L], serum KL-6[（5.9±0.6）pg/m L vs（6.5±0.7）pg/m L] and NF-κB[（7.8±0.4）pg/m L vs（8.1±0.3）pg/m L] in the two groups were significantly lower than those before treatment, and those in the study group were lower than the control group（P 〈 0.05）. The extinction time o

关 键 词：甘利欣 阿奇霉素 支原体肺炎 肝功能损害 血清炎症因子 KL-6 NF-κB 

分 类 号：R725.6[医药卫生—儿科]