纤支镜灌洗联合亚胺培南对重症肺部感染患儿肺功能及血清MIP-1α、PCT水平的影响  

Effect of fiberoptic bronchoscopy lavage combined with imipenem on lung function and serum levels of MIP-1α and PCT in children with severe pulmonary infection

作　　者：万玉[1] 车晓晴 王沛 赵晓红[1] WAN Yu;CHE Xiao-qing;WANG Pei;ZHAO Xiao-hong(Department of Pediatrics,Luohe Central Hospital,Luohe 462000,Henan,CHINA)

机构地区：[1]漯河市中心医院儿科,河南漯河462000

出　　处：《海南医学》2023年第16期2349-2353,共5页Hainan Medical Journal

基　　金：河南省科技攻关项目(编号:212102310574)。

摘　　要：目的探究纤维支气管镜(纤支镜)灌洗联合亚胺培南对重症肺部感染患儿肺功能及血清巨噬细胞炎性蛋白-1α(MIP-1α)、降钙素原(PCT)水平的影响。方法前瞻性选取2020年3月至2022年1月漯河市中心医院收治的92例重症肺部感染患儿为研究对象,根据随机数表法分为观察组和对照组各46例。对照组患儿给予亚胺培南治疗,观察组患儿给予纤支镜灌洗联合亚胺培南治疗,均连续治疗7 d。比较两组患儿的疗效、治疗前后的肺功能[肺总量(TLC)、最大呼气中期流量(MMEF)、第1秒最大呼吸容积(FEV_(1))、最大通气量(MMV)]、临床肺部感染评分(CPIS)、血清MIP-1α水平、PCT水平,同时比较两组患儿的住院天数、症状恢复时间和不良反应发生情况。结果观察组患儿的治疗总有效率为97.83%,明显高于对照组的82.61%,差异有统计学意义(P<0.05);治疗后,观察组患儿的TLC、MMEF、MMV、FEV_(1)水平分别为(5.36±0.71)L、(3.27±0.52)L/s、(95.62±12.33)L、(2.97±0.43)L,明显高于对照组的(4.50±0.58)L、(2.40±0.44)L/s、(84.24±10.62)L、(2.24±0.26)L,差异均有统计学意义(P<0.05);观察组患儿的住院天数为(10.33±0.12)d,明显少于对照组的(15.42±0.16)d,症状恢复时间[发热消失(6.14±2.25)d、啰音消失(9.22±1.18)d、咳嗽消失(9.72±2.80)d、白细胞恢复(3.71±0.48)d]明显短于对照组[(10.76±3.06)d、(10.91±1.27)d、(12.62±3.53)d、(5.70±0.65)d],差异均有统计学意义(P<0.05);治疗后,观察组患儿的CPIS评分为(6.33±0.17)分,明显低于对照组的(7.84±0.25)分,差异有统计学意义(P<0.05);治疗后,观察组患儿的血清MIP-1α、PCT水平分别为(20.63±2.24)pg/mL、(0.56±0.17)ng/mL,明显低于对照组的(36.09±3.18)pg/mL、(1.40±0.15)ng/mL,差异均有统计学意义(P<0.05);治疗期间,观察组患儿的不良反应总发生率为8.70%,略低于对照组的15.22%,但差异无统计学意义(P>0.05)。结论纤支镜灌洗联合亚胺培南治疗重症肺部感Objective To explore the effect of fiberoptic bronchoscopy lavage combined with imipenem on pulmonary function and serum levels of macrophage inflammatory protein-1α(MIP-1α)and procalcitonin(PCT)in children with severe pulmonary infection.Methods A total of 92 cases of children with severe pulmonary infection admitted to Luohe Central Hospital from March 2020 to January 2022 were prospectively selected and divided into the observation group and the control group according to the random number table method(each with 46 cases).The children in the control group were treated with imipenem,while the children in the observation group were treated with fiberoptic bronchoscopy lavage combined with imipenem,continuously for 7 d.The efficacy,pulmonary function[total lung capacity(TLC),maximum mid-expiratory flow(MMEF),forced expiratory volume in the first second(FEV1),maximum ventilation(MMV)],clinical pulmonary infection score(CPIS),serum MIP-1αand PCT levels before and after treatment were compared between the two groups,along with the length of hospital stay,time to recovery from symptoms,and the occurrence of adverse effects.Results The total effective rate of treatment for the children in the observation group was 97.83%,which was significantly higher than 82.61% of the control group,and the difference was statistically significant(P<0.05);after treatment,the TLC,MMEF,MMV,and FEV1 levels of the children in the observation group were(5.36±0.71)L,(3.27±0.52)L/s,(95.62±12.33)L,(2.97±0.43)L,significantly higher than(4.50±0.58)L,(2.40±0.44)L/s,(84.24±10.62)L,(2.24±0.26)L in the control group,all with statistically significant differences(P<0.05).The length of hospital stay for patients in the observation group was(10.33±0.12)d,which was significantly less than(15.42±0.16)d of the control group.The recovery time of symptoms[disappearance of fever(6.14±2.25)d,disappearance of rales(9.22±1.18)d,disappearance of cough(9.72±2.80)d,recovery of white blood cells(3.71±0.48)d]was significantly shorter than those[(1

关 键 词：重症肺部感染 亚胺培南 纤支镜 灌洗 巨噬细胞炎性蛋白-1Α 降钙素原 

分 类 号：R726[医药卫生—儿科]