特应质肺炎支原体肺炎患儿糖皮质激素受体水平及糖皮质激素干预疗效观察  

Observation of effect of glucocorticoid intervention and glucocorticoid receptor level in children with Mycoplasma pneumoniae infection

作　　者：王蕴娴 李静 WANG Yun-xian;LI Jing(Hengshui Second People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市二院,河北衡水053000

出　　处：《临床肺科杂志》2021年第12期1852-1856,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究特应质肺炎支原体肺炎患儿糖皮质激素受体水平及糖皮质激素干预疗效。方法纳入200例肺炎支原体肺炎患儿为研究对象,根据是否为特应性体质将患儿分为特应质组78例和非特应质组122例,比较两组血清糖皮质激素受体α(GRα)、糖皮质激素受体β(GRβ)水平及GRα/GRβ值。对特应质和非特应质患儿均采取阿奇霉素治疗和阿奇霉素联合糖皮质激素治疗两种方式,比较患儿经激素治疗和非激素治疗疗效,分析治疗前后肺功能指标用力肺活量(FVC)、第一秒用力呼气容积(FEV_(1))及炎性指标C-反应蛋白(CRP)、白细胞介素-6(IL-6)、嗜酸性粒细胞计数(EOS)水平,并观察治疗期间不良反应发生情况。结果特应质组GRα、GRα/GRβ水平均显著高于非特应质组(P<0.05)。非特应质组经激素治疗患儿治疗总有效率均显著高于非激素治疗患儿(P<0.05),但非特应质组经激素治疗患儿治疗总有效率之间的差异不显著(P>0.05)。两组经不同治疗方式治疗后FVC、FEV_(1)均显著高于治疗前(P<0.05),CRP、IL-6、EOS均显著低于治疗前(P<0.05);两组经激素治疗患儿,治疗后FVC、FEV_(1)均显著高于非激素治疗患儿治疗后(P<0.05),CRP、IL-6、EOS均显著低于非激素治疗患儿治疗后(P<0.05);特应质组激素治疗后CRP、EOS均显著低于非特应质组激素治疗后(P<0.05)。两组经不同治疗方式治疗,不良反应发生率比较差异均无统计学意义(P>0.05)。结论采用糖皮质激素治疗特应质肺炎支原体肺炎患儿,可有效改善患儿肺功能,降低炎症反应,疗效确切,其作用机制可能与特应质患儿糖皮质激素受体水平较高有关。Objective To study the effect of glucocorticoid intervention in children with Mycoplasma pneumoniae infection,and to observe the level of glucocorticoid receptor.Methods 200 children with Mycoplasma pneumoniae infection in our hospital from April 2019 to April 2020 were included as the research objects.According to the atopic constitution,the children were divided into the atopic group(n=78)and the non atopic group(n=122).The serum levels of glucocorticoid receptorα(GRα),glucocorticoid receptorβ(GRβ)and GRα/GRβwere compared between the two groups.Both atopic and non atopic children were treated with azithromycin and azithromycin combined with glucocorticoid.The therapeutic effect of steroid therapy and non steroid therapy were compared.The pulmonary function indexes such as forced vital capacity(FVC),forced expiratory volume(FEV_(1)),C-reactive protein(CRP),interleukin-6(IL-6),and EOS level were analyzed before and after treatment,and the incidence of adverse reactions during the treatment was observed.Results The levels of GRαand GRα/GRβin the atopic group were significantly higher than those in the non atopic group(P<0.05).The total effective rate of the non atopic group treated with hormone was significantly higher than the non atopic group(P<0.05),but there was no significant difference in the total effective rate of the non atopic group treated with hormone(P>0.05).FVC and FEV_(1) of the two groups after treatment were significantly higher than those before treatment(P<0.05),while CRP,IL-6 and EOS were significantly lower than those before treatment(P<0.05).FVC and FEV_(1) of the two groups after treatment were significantly higher than those after non hormone treatment(P<0.05),while CRP,IL-6 and EOS were significantly lower than those after non hormone treatment(P<0.05).CRP and EOS in the atopic group were significantly lower than those in the non atopic group after hormone treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Con

关 键 词：肺炎支原体肺炎 特应质 糖皮质激素受体 儿童 

分 类 号：R725.6[医药卫生—儿科]