支气管镜灌洗治疗急性期儿童大叶性肺炎疗效及对血清TNF-α、IL-6和HMGB1的影响  

Efficacy of fiberoptic bronchoscopy lavage on acute lobar pneumonia in children and its effects on serum TNF-α,IL-6 and HMGB1

作　　者：徐慧[1] 陈敏[1] 孙永峰 程星[1] 王琦 靳蓉[1] XU Hui;CHEN Min;SUN Yong-feng;CHENG Xing;WANG Qi;JIN Rong(Respiratory Department,Guiyang Maternal and Child Health Hospital,Guiyang 550003,Guizhou,China)

机构地区：[1]贵阳市妇幼保健院呼吸科,贵州贵阳550003

出　　处：《广东医学》2021年第3期264-268,共5页Guangdong Medical Journal

基　　金：贵阳市科技计划项目(筑科合同[2015001]社13号)

摘　　要：目的探讨电子支气管镜灌洗治疗急性期儿童大叶性肺炎疗效,及其对患儿血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和高迁移率族蛋白B-1(HMGB1)水平的影响。方法将收治的286例大叶性肺炎急性期患儿进行随机分组,即对照组和观察组各143例,对照组给予常规治疗,观察组基于以上治疗基础上加予电子支气管镜灌洗治疗,评估两组患儿临床疗效,观察两组患儿咳嗽咳痰缓解时间、退热时间、肺部体征消失时间及住院时间,对比两组患儿治疗前及治疗1个月后的呼吸力学和血清炎症因子水平。结果观察组的临床总有效率显著高于对照组(93.01%vs 82.52%,P<0.05)。观察组的咳嗽咳痰缓解时间、退热时间、肺部体征消失时间及住院时间均显著短于对照组(P<0.05)。治疗后,两组患儿关于呼吸力学参数指标中的肺阔顺应性、肺顺应及总动态顺应性显著高于治疗前(P<0.05),两组患儿的血清TNF-α、IL-6和HMGB1水平显著低于治疗前(P<0.05),观察组以上指标显著高于对照组(P<0.05);两组患儿均未发现明显治疗不良反应。结论支气管镜灌洗应用于急性期儿童大叶性肺炎治疗中疗效显著,能明显改善患儿咳嗽、咳痰、发热等症状体征,改善其呼吸力学和炎症反应,有助于患儿快速康复出院,临床应用安全性佳。Objective To investigate the efficacy of fiberoptic bronchoscopy lavage on the treatment of acute lobar pneumonia in children,and its effects on levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high mobility group protein B-1(HMGB1).Methods A total of 286 children patients with acute lobar pneumonia admitted from March 2015 to March 2016 were randomly grouped into control group(143 cases)and observation group(143 cases).Control group was given with routine treatment,and observation group was given with fiberoptic bronchoscopy lavage based on the above treatment.The clinical efficacy was evaluated.The relief time of cough and expectoration,abatement time of fever,disappearance time of lung signs and hospital stay were observed in the two groups.Respiratory mechanics and serum inflammatory indexes were compared between the two groups before treatment and after 1 month of treatment.Results The total clinical effective rate in observation group was significantly higher than that in control group(93.01%vs.82.52%,P<0.05).The relief time of cough and expectoration,abatement time of fever,disappearance time of lung signs and hospital stay in observation group were significantly shorter than those in control group(P<0.05).After treatment,the respiratory mechanics parameters of lung inflation compliance,lung compliance and total dynamic compliance in the two groups were significantly higher than those before treatment(P<0.05);the levels of serum TNF-α,IL-6 and HMGB1 in the two groups were significantly lower than those before treatment(P<0.05);and the changes of the above indexes in observation group were significantly greater than those in control group(P<0.05).There were no obvious adverse treatment reactions in the two groups.Conclusions Fiberoptic bronchoscopy lavage has significant efficacy on the treatment of acute lobar pneumonia in children.And it can significantly improve the symptoms and signs of cough,expectoration and fever,improve the respiratory mechanics and inflammatory response,and

关 键 词：支气管镜灌洗 急性期儿童大叶性肺炎 肿瘤坏死因子-α 白细胞介素-6 高迁移率族蛋白B-1 

分 类 号：R725.6[医药卫生—儿科] R974[医药卫生—临床医学]