免疫球蛋白辅助益生菌对轮状病毒肠炎婴幼儿病程、细菌感染率及S IgA水平的影响  

Effect of immunoglobulin assisted probiotics on course of disease, bacterial infection rate, and secretory IgA levels in infants with rotavirus enteritis

作　　者：刘冬 王金珠 Dong Liu Jin-Zu Wang(Department of Pediatrics, Tianjin Ninghe District Hospital, Tianjin 301500, China)

机构地区：[1]天津市宁河区医院儿科,天津市301500

出　　处：《世界华人消化杂志》2017年第27期2486-2490,共5页World Chinese Journal of Digestology

摘　　要：目的研究免疫球蛋白辅助益生菌对轮状病毒肠炎婴幼儿病程、细菌感染率及分泌性IgA(secretory IgA,SIgA)水平的影响.方法选择2015-01/2016-12在天津市宁河区医院治疗的轮状病毒肠炎患儿120例.用随机数表法分为对照组和观察组,每组各60例,对照组患儿给予常规治疗联合酪酸梭菌活菌散治疗,观察组患儿在对照组的基础上加用免疫球蛋白治疗.比较2组患儿的病程、腹泻次数、细菌感染率及SIgA水平等.结果观察组患儿治疗3、5、7和9 d的腹泻次数分别为5.62次±1.38次、3.49次±0.87次、2.25次±0.74次和1.27次±0.51次,平均病程为4.15 d±0.93 d,均低于对照组,差异有统计学意义(P<0.05).治疗前2组患儿的SIgA水平、轮状病毒含量及炎性因子水平相近(P>0.05),治疗后观察组患儿的SIgA水平高于对照组(4.25±0.39 vs 2.84±0.35),轮状病毒含量(0.13±0.03 vs 0.52±0.09)、白介素-6(15.02±3.62 vs 19.47±4.02)和肿瘤坏死因子-α(2.47±0.62 vs 3.26±0.71)水平低于对照组(P<0.05).治疗前2组患儿的细胞免疫指标水平相近(P>0.05),治疗后观察组患儿的CD3^+(67.51±12.95 vs 59.15±10.83)、CD4^+(36.95±6.51 vs 32.71±5.29)和CD4^+/CD8^+(1.47±0.38 vs 1.21±0.27)水平高于对照组,CD8^+(23.16±3.01 vs 28.03±3.64)水平低于对照组,差异有统计学意义(P<0.05).观察组患儿有4例发生细菌感染,发生率为6.67%,对照组患儿有12例发生细菌感染,发生率为20.00%,差异有统计学意义(χ~2=4.615,P<0.05).结论免疫球蛋白辅助益生菌可以明显改善轮状病毒肠炎婴幼儿的免疫功能,提高SIgA水平,明显缓解临床症状,有益于肠道内轮状病毒的清除,缩短病程,值得在临床推广.AIM To investigate the effect of immunoglobulin assisted probiotics on the course of disease,bacterial infection rate, and secretory IgA（SIgA） level in infants with rotavirus enteritis.METHODS One hundred and twenty children with rotavirus enteritis who were treated at our hospital from January 2015 to December 2016 were selected and randomly divided into either a control group or an observation group, with 60 cases in each group. Both groups were given routine treatment combined with Clostridium butyricum powder, and the observation group was additionally given immunoglobulins. The course of disease, the frequency of diarrhea, the rate of bacterial infection, and the levels of SIgA were compared between the two groups.RESULTS The frequency of diarrhea at 3, 5, 7, and 9 d was 5.62 ± 1.38, 3.49 ± 0.87, 2.25 ± 0.74, and 1.27 ± 0.51, respectively, in the observation group, and the average duration of disease was 4.15 d ± 0.93 d, all of which were significantly lower than those in the control group（P 0.05）. Before treatment, the levels of SIgA, rotavirus contents, and inflammatory factor levels were similar between the two groups（P 0.05）. After treatment, the level of SIgA（4.25 ± 0.39 vs 2.84 ± 0.35） was significantly higher, and the content of rotavirus（0.13 ± 0.03 vs 0.52 ± 0.09） and the levels of interleukin-6（15.02 ± 3.62 vs 19.47 ± 4.02） and tumor necrosis factor-α（2.47 ± 0.62 vs 3.26 ± 0.71） were significantly lower in the observation group than in the control group（P 0.05）. Before treatment, cellular immunity levels in the two groups weresimilar（P 0.05）. After treatment, the levels of CD3~＋（67.51 ± 12.95 vs 59.15 ± 10.83） and CD4~＋ cells（36.95 ± 6.51 vs 32.71 ± 5.29） and CD4~＋/CD8~＋ ratio（1.47 ± 0.38 vs 1.21 ± 0.27） were significantly higher, and the level of CD8~＋ cells（23.16 ± 3.01 vs 28.03 ± 3.64） was significantly lower in the observation group than in the control group（P 0.05）. There were four cases of bacterial infect

关 键 词：免疫球蛋白 酪酸梭菌活菌散 轮状病毒肠炎 分泌性IGA 

分 类 号：R725.1[医药卫生—儿科]