人免疫球蛋白联合经鼻高流量湿化氧疗辅助治疗重症新生儿肺炎的临床效果  

Clinical analysis of human immunoglobulin combined with transnasal high flow humidification oxygen therapy in the treatment of severe neonatal pneumonia

作　　者：刘倩[1] 闫俊梅[1] Liu Qian;Yan Junmei(Xuzhou Maternal and Child Health Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市妇幼保健院,江苏徐州221000

出　　处：《国际免疫学杂志》2021年第3期274-279,共6页International Journal of Immunology

摘　　要：目的观察人免疫球蛋白联合经鼻高流量湿化氧疗辅助治疗重症新生儿肺炎的临床效果。方法选取2018年1月至2018年12月于徐州市妇幼保健院生产且于本院重症加强护理病房(intensive care unit,ICU)接受治疗的84例重症肺炎新生儿,按信封随机数字法分为球蛋白组(42例)和蛋白氧疗组(42例)。在重症肺炎常规治疗基础上,球蛋白组给予人免疫球蛋白,蛋白氧疗组给予人免疫球蛋白(同球蛋白组)联合经鼻高流量湿化氧疗。观察球蛋白组和蛋白氧疗组治疗一周后临床疗效及血清免疫球蛋白、临床症状、血清炎性因子的改善情况。结果治疗前,球蛋白组和蛋白氧疗组血清免疫球蛋白(immunoglobulin,Ig)A、IgG和IgM差异无统计学意义(P>0.05)。治疗后,球蛋白组和蛋白氧疗组血清Ig A、Ig G和IgM均较治疗前明显提升,差异有统计学意义(球蛋白组:t值分别为9.253、8.017和6.110,蛋白氧疗组:t值分别为6.012、6.923和5.841,P值均<0.05),且蛋白氧疗组IgA、IgG和IgM表达水平较蛋白组明显升高,差异有统计学意义(t值分别为6.101、5.837和3.214,P值均<0.05)。治疗后,蛋白氧疗组退热时间、肺部啰音消失时间、咳嗽缓解时间均优于球蛋白组,两组比较差异具有统计学意义(t值分别为20.684、12.592和20.221,P值均<0.05);蛋白氧疗组住院时间短于球蛋白组,差异具有统计学意义(t=9.529,P<0.05)。治疗后,球蛋白组和蛋白氧疗组血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素1β(interleukin-1β,IL-1β)、基金金属蛋白酶9(matrix metalloprotein-9,MMP-9)均较治疗前显著下降(球蛋白组:t值分别为11.232、10.017和9.823,蛋白氧疗组:t值分别为7.235、11.012和7.210,P值均<0.05);蛋白氧疗组降幅更大,与球蛋白组相比差异具有统计学意义(t值分别为10.312、8.017和9.220,P值均<0.05)。蛋白氧疗组临床总有效率为95.24%,高于球蛋白组的80.95%,组间差异具有统计学意�Objective To observe the clinical effect of human immunoglobulin combined with transnasal high flow humidification oxygen therapy in the treatment of severe neonatal pneumonia.Methods Total of 84 neonates with severe pneumonia who were born in Xuzhou Maternal and Child Health Hospital and treated in intensive care unit(ICU)were selected from January 2018 to December 2018.All the neonates randomly divided into globulin group(42 cases)and protein oxygen therapy group(42 cases)according to envelope random number method.On the basis of routine treatment of severe pneumonia,the globulin group was treated with human immunoglobulin once a day,and the albumin oxytherapy group was treated with human immunoglobulin(same as the globulin group)combined with nasal high-flow humidification oxygen therapy.The clinical efficacy,serum immunoglobulin,clinical symptoms and serum inflammatory factors in globulin group and protein oxygen therapy group were observed after one week of treatment.Results Before treatment,there were no significant difference in the expression of serum immunoglobulin(Ig)A,IgG and IgM between the globulin group and protein oxygen therapy group(P>0.05).After treatment,serum IgA,IgG and IgM in globulin group and protein oxygen therapy group were significantly higher than those before treatment(globulin group:t values were 9.253,8.017 and 6.110 respectively,protein oxygen therapy group:t values were 6.012,6.923 and 5.841 respectively,all P values<0.05).The expression of IgA,IgG and IgM in protein oxygen therapy group were significantly higher than in protein group(t values were 6.101,5.837,3.214 respectively,all P values<0.05).After treatment,the antipyretic time,pulmonary rales disappearance time and cough relief time of the protein oxygen therapy group were significantly better than those of the globulin group(t values were 20.684,12.592 and 20.221 respectively,all P values<0.05).The hospitalization time of the protein oxygen therapy group was statistically shorter than that of the globulin group(t=9.529,P<0

关 键 词：人免疫球蛋白 经鼻高流量湿化氧疗 重症肺炎 新生儿 

分 类 号：R722.135[医药卫生—儿科]