万古霉素联合丙种球蛋白对新生儿败血症神经系统症状及炎症介质水平的影响  

The Effect of Vancomycin Combined With Immunoglobulin on Neurological Symptoms and Inflammatory Mediator Levels in Neonatal Sepsis

作　　者：刘峰 唐妮 章飞辉 LIU Feng;TANG Ni;ZHANG Feihui(Department of Neonatology,the People's Hospital of Xiangxiang,Xiangxiang Hu'nan 411400,China)

机构地区：[1]湘乡市人民医院新生儿科,湖南湘乡411400

出　　处：《中国卫生标准管理》2024年第9期142-145,共4页China Health Standard Management

摘　　要：目的探讨万古霉素联合丙种球蛋白对新生儿败血症神经系统症状及炎症介质水平的影响。方法选取2020年4月—2023年3月湘乡市人民医院新生儿科收治的90例新生儿败血症患儿,随机分为对照组(n=45)和观察组(n=45)。2组均给予常规对症治疗(保暖、吸氧、机械通气、纠正水电解质平衡等),对照组在常规对症治疗的基础上给予万古霉素治疗,观察组在对照组基础上联合丙种球蛋白治疗。2组均连续治疗3 d,比较2组的临床疗效、症状改善时间(神经系统症状改善时间、拒奶改善时间、体温正常时间、病原体检查转阴时间)及炎症指标[白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)及降钙素原(procalcitonin,PCT)],并记录2组治疗期间不良反应发生率。结果观察组总有效率(95.56%)高于对照组(80.00%),差异有统计学意义(P<0.05)。观察组神经系统症状改善、体温正常、据奶改善及病原体检查转阴时间均短于对照组(P<0.05)。治疗后,2组IL-6、CRP及PCT均下降,且观察组低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论万古霉素联合丙种球蛋白治疗新生儿败血症,可促进患儿神经系统症状恢复,抑制血清炎症指标水平,且不增加不良反应情况。Objective To investigate the effect of vancomycin combined with gamma globulin on neurological symptoms and inflammatory mediators in neonatal sepsis.Methods A total of 90 children with neonatal sepsis admitted to the department of neonatology of the People's Hospital of Xiangxiang from April 2020 to March 2023 were randomly divided into control group(n=45)and observation group(n=45).Both groups were given conventional symptomatic treatment(warmth,oxygen inhalation,mechanical ventilation,correction of water and electrolyte balance,etc.),the control group was given vancomycin treatment on the basis of conventional symptomatic treatment,and the observation group was combined with gamma globulin treatment on the basis of the control group.The two groups were treated continuously for 3 days.The clinical efficacy,symptom improvement time[nervous system symptom improvement time,milk rejection improvement time,normal temperature time,pathogen detection negative time]and inflammatory indicators[interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)]of the two groups were compared.The incidence of adverse reactions during treatment was recorded in both groups.Results The total effective rate of the observation group(95.56%)was higher than that of the control group(80.00%),and the difference was statistically significant(P<0.05).The improvement of neurological symptoms,normal body temperature,improvement of milk and negative conversion time of pathogen examination in the observation group were shorter(P<0.05).After treatment,the inflammatory indicators IL-6,CRP and PCT were decreased in both groups,and lower in observation group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Vancomycin combined with gamma globulin in the treatment of neonatal sepsis,can promote the recovery of neurological symptoms,inhibit the level of serum inflammatory indicators,and do not increase the adverse reactions.

关 键 词：新生儿败血症 万古霉素 丙种球蛋白 神经系统 炎症 疗效 

分 类 号：R722[医药卫生—儿科]