免疫球蛋白静脉滴注辅助治疗小儿重症肺炎的疗效及对体液免疫、炎症反应的影响  

Curative effect of immunoglobulin intravenous drip adjuvant therapy in treatment of children with severe pneumonia and the effect on humoral immunity and inflammation status of children

作　　者：王丽[1] 黄娟[1] 冷红春[1] 

机构地区：[1]湖北省妇幼保健院急诊科,湖北武汉430070

出　　处：《中国妇幼保健》2017年第18期4425-4428,共4页Maternal and Child Health Care of China

基　　金：湖北省自然基金课题项目基金(2013CF8048)

摘　　要：目的观察免疫球蛋白(Ig)静脉滴注辅助治疗小儿重症肺炎的疗效及对体液免疫、炎症状态的影响。方法选择2014年6月-2016年10月在湖北省妇幼保健院就诊的58例重症肺炎患儿并随机分为两组,观察组在常规治疗基础上加用Ig治疗,对照组采用常规治疗。治疗后,评估整体疗效、临床症状和体征的转归情况,采集血清并测定体液免疫指标IgG1、IgG2、IgG3、IgG4以及炎症反应指标肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、可溶性细胞间黏附分子-1(s ICAM-1)和干扰素-γ(IFN-γ)的含量。结果观察组患儿的总有效率明显高于对照组(P<0.05),发热持续时间、咳嗽缓解时间、肺部湿啰音和哮鸣音消失时间均明显短于对照组(P<0.05);治疗后1周时,两组患儿血清中IgG1、IgG2、IgG3和IgG4的含量均明显高于治疗前(P<0.05),TNF-α、CRP、sICAM-1和IFN-γ的含量均明显低于治疗前且观察组患儿血清中IgG1、IgG2、IgG3和IgG4的含量明显高于对照组(P<0.05),TNF-α、CRP、sICAM-1和IFN-γ的含量均明显低于对照组(P<0.05)。结论免疫球蛋白辅助治疗小儿重症肺炎能够改善疗效及病情转归,增强体液免疫功能、减轻炎症反应程度。Objective To observe the curative effect of immunoglobulin intravenous drip adjuvant therapy in treatment of children with severe pneumonia and the effect on humoral immunity and inflammation status of children. Methods Fifty-eight children with severe pneu- monia treated in the hospital from June 2014 to October 2016 were selected and randomly divided into two groups, the patients in observation group were treated by immunoglobalin combined with conventional treatment, and the patients in control group were treated by conventional treatment. After treatment, the overall curative effect, prognosis of clinical symptoms and signs were evaluated, serum samples were collected, the levels of humoral immunity indexes （IgGl, IgG2, IgG3, and IgG4） and inflammatory response indexes [ tumor necrosis factor-α （TNF-α） , C-reactive protein （CRP） , soluble intercellular adhesion molecule- 1 （ sICAM- 1 ） , and interferon-γ （IFN-γ） ] were deter- mined. Results The total effective rate in observation group was statistically significantly higher than that in control group （P〈0. 05 ） ; the duration time of fever, cough relief time, disappearance time of lung wet rales and wheezing in observation group was statistically significantly shorter than that in control group （P〈0. 05 ） . After one week of treatment, the levels of serum IgG1, IgG2, IgG3, and IgG4 in the two groups were significantly higher than those before treatment （P〈0. 05 ） ; the levels of TNF-α, CRP, sICAM-1, and IFN-γ were significant- ly lower than those before treatment ; the levels of serum IgG1, IgG2, IgG3, and IgG4 in observation group were significantly higher than those in control group （P〈0. 05 ） ; the levels of TNF-α, CRP, sICAM-1, and IFN-γ in observation group were significantly lower than those in control group （ P〈0. 05 ） . Conclusion Immunoglobulin adjuvant therapy can improve curative effect and prognosis of the disease, enhance humoral immune function, and reduce the level of inflammatory reacti

关 键 词：重症肺炎 免疫球蛋白 体液免疫 炎症反应 

分 类 号：R725.6[医药卫生—儿科]