谷氨酰胺颗粒联合纤维支气管镜治疗对儿童支原体肺炎支气管黏膜损伤修复和炎症反应水平的影响  

Effect of glutamine granules combined with bronchofiberscope in the treatment of children's mycoplasma pneumonia on the repair of bronchial mucosa damage and the level of inflammatory reaction

作　　者：寇志军 马亨曼 全守东 孙桂林 马艳华 李娜 KOU Zhi-jun;MA Heng-man;QUAN Shou-dong(Department of Paediatrics,the Second Hospital of Chaoyang City,Chaoyang Liaoning 122000,China;Internal Medicine,the Second Hospital of Chaoyang City,Chaoyang Liaoning 122000,China)

机构地区：[1]朝阳市第二医院儿科,辽宁朝阳122000 [2]朝阳市第二医院内科,辽宁朝阳122000 [3]大连医科大学附属大连市儿童医院小儿呼吸科,辽宁大连116012

出　　处：《临床和实验医学杂志》2022年第4期433-436,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察谷氨酰胺颗粒联合纤维支气管镜治疗对儿童支原体肺炎支气管黏膜损伤修复和炎症反应水平的影响。方法前瞻性选取朝阳市第二医院儿科于2018年1月至2021年1月收治的支原体肺炎患儿82例,采用奇偶数分组法分为两组。纤维支气管镜组41例给予纤维支气管镜治疗,谷氨酰胺组41例给予谷氨酰胺颗粒联合纤维支气管镜治疗。统计两组患儿的总有效率、支气管镜下黏膜修复率和不良反应率;检测两组患儿治疗前后肺泡灌洗液中细胞因子[干扰素-γ(IFN-γ)、白细胞介素(IL)-8、IL-12、肺表面活性蛋白-A(SP-A)、Toll样受体2(TLR2)、粒细胞巨噬细胞集落刺激因子(GM-CSF)]的水平。结果谷氨酰胺组治疗总有效率、镜下黏膜修复率为92.68%、78.05%,显著高于纤维支气管镜组的75.61%、56.10%,差异均有统计学意义(P<0.05)。谷氨酰胺组与纤维支气管镜组不良反应发生率比较(9.32%vs.12.20%),差异无统计学意义(P>0.05)。治疗后,两组患儿肺泡灌洗液中IFN-γ、IL-8、IL-12、SP-A、TLR2、GM-CSF水平均低于治疗前,差异均有统计学意义(P<0.05);且谷氨酰胺组患儿肺泡灌洗液中IFN-γ、IL-8、IL-12、SP-A、TLR2、GM-CSF水平分别为(42.58±8.76)ng/L、(941.23±121.05)ng/L、(32.04±2.97)ng/L、(0.33±0.08)g/L、(12.21±2.05)μg/L、(121.47±8.89)ng/L,均低于纤维支气管镜组[(51.22±11.36)ng/L、(1148.25±174.51)ng/L、(35.12±3.25)ng/L、(0.41±0.10)g/L、(15.74±2.23)μg/L、(132.25±12.04)ng/L],差异均有统计学意义(P<0.05)。结论谷氨酰胺颗粒联合纤维支气管镜治疗儿童支原体肺炎可降低IFN-γ、IL-8、TLR2、GM-CSF等相关因子的表达,减轻炎症反应,促进支气管黏膜损伤修复,提高疗效。Objective To observe the effect of glutamine granules combined with bronchofiberscopy in the treatment of childhood mycoplasma pneumonia on the repair of bronchial mucosal injury and the level of inflammatory response in children.Methods A total of 82 children with mycoplasma pneumonia treated in Department of Paediatrics,the Second Hospital of Chaoyang City from January 2018 to January 2021 were prospectively divided into two groups by odd even grouping method.Forty-one cases were treated with fiberoptic bronchoscopy,and 41 cases in glutamine group were treated with glutamine granules combined with fiberoptic bronchoscopy.The total effective rate,mucosal repair rate and adverse reaction rate under bronchoscopy were counted,and the levels of cytokines in alveolar lavage fluid[interferon-gamma(IFN-γ),interleukin(IL)-8,IL-12,pulmonary surfactant protein-A(SP-A),Toll-like receptor 2(TLR2),granulocyte macrophage colony stimulatory factor(GM-CSF)]were detected.Results The total effective rate and mucosal repair rate under the microscope in the glutamine group were 92.68%and 78.05%,which were significantly higher than those in the bronchoscopy(75.61%and 56.10%),and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the glutamine group and the bronchoscopy group(9.32%vs.12.20%)(P>0.05).After treatment,the levels of IFN-γ,IL-8,IL-12,SP-A,TLR2 and GM-CSF in bronchoalveolar lavage fluid of the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05);and the levels of IFN-γ,IL-8,IL-12,SP-A,TLR2,and GM-CSF in the bronchoalveolar lavage fluid of the children in the glutamine group were(42.58±8.76)ng/L,(941.23±121.05)ng/L,(32.04±2.97)ng/L,(0.33±0.08)g/L,(12.21±2.05)μg/L,(121.47±8.89)ng/L,which were lower than those in the bronchoscopy group[(51.22±11.36)ng/L,(1148.25±174.51)ng/L,(35.12±3.25)ng/L,(0.41±0.10)g/L,(15.74±2.23)μg/L,(132.25±12.04)ng/L],the differences were statist

关 键 词：儿童支原体肺炎 谷氨酰胺颗粒 纤维支气管镜 支气管黏膜损伤 疗效 

分 类 号：R725.6[医药卫生—儿科]