支气管镜介入治疗对RMPP患儿的疗效及其对外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值的影响  

The effect of bronchoscopic interventional therapy on children with RMPP and its effect on peripheral blood CRP,SF,IL-8 levels and CD4^(+)/CD8^(+)ratio

作　　者：牛波[1] 池跃朋[2] 黄坤玲[1] 褚亚娟 刘建华[1] 帅金凤[1] 杨会荣[1] 李甜 NIU Bo;CHI Yuepeng;HUANG Kunling;CHU Yajuan;LIU Jianhua;SHUAI Jinfeng;YANG Huirong;LI Tian(The Second Department of Respiratory Medicine,Children′s Hospital of Hebei Province,Shijiazhuang,Hebei 050041,China;The Second Department of Tuberculosis,Hebei Chest Hospital,Shijiazhuang,Hebei 050040,China)

机构地区：[1]河北省儿童医院呼吸二科,河北石家庄050041 [2]河北省胸科医院结核二科,河北石家庄050040

出　　处：《检验医学与临床》2024年第22期3265-3269,共5页Laboratory Medicine and Clinic

基　　金：河北省医学研究科学基金项目(20241722)。

摘　　要：目的探讨支气管镜介入治疗对难治性肺炎支原体肺炎(RMPP)患儿的疗效及其对外周血C反应蛋白(CRP)、铁蛋白(SF)、白细胞介素(IL)-8水平及CD4^(+)/CD8^(+)比值的影响。方法选取2020年12月至2022年12月河北省儿童医院收治的195例确诊为RMPP患儿作为研究对象,采用随机数字表法分为对照组和介入组(病程≥14 d归为晚期介入组、病程<14 d归为早期介入组)。根据临床疗效将130例接受支气管镜介入治疗的患儿分为有效组和无效组。对照组进行常规治疗,晚期介入组和早期介入组在对照组的基础上实施支气管镜介入治疗。比较对照组、晚期介入组和早期介入组临床疗效、临床症状与体征改善情况;检测并比较对照组、晚期介入组和早期介入组外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值;比较对照组、晚期介入组和早期介入组不良反应发生率;比较有效组和无效组外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值。采用受试者工作特征(ROC)曲线分析外周血CRP、SF、IL-8、CD4^(+)/CD8^(+)比值对支气管镜介入治疗RMPP疗效的预测价值。结果早期介入组总有效率高于对照组和晚期介入组,差异均有统计学意义(P<0.05);对照组和晚期介入组总有效率比较,差异无统计学意义(P>0.05)。早期介入组咳嗽持续时间、发热持续时间、住院时间均短于对照组和晚期介入组,差异均有统计学意义(P<0.05)。对照组、晚期介入组和早期介入组治疗后外周血CD4^(+)/CD8^(+)比值均高于治疗前,CRP、SF、IL-8水平均低于治疗前,差异均有统计学意义(P<0.05);早期介入组治疗后外周血CD4^(+)/CD8^(+)比值均高于对照组和晚期介入组,CRP、SF、IL-8水平均低于对照组和晚期介入组,差异均有统计学意义(P<0.05)。早期介入组出现不良反应8例,晚期介入组出现不良反应10例,均暂停灌洗操作后很快恢复。对照组未出现上述不良反应。无效组外周血CRObjective To investigate the effect of bronchoscopic interventional therapy on children with refractory mycoplasma pneumoniae pneumonia(RMPP)children and its effect on the levels of peripheral blood C-reactive protein(CRP),ferritin(SF),interleukin(IL)-8 and CD4^(+)/CD8^(+)ratio.Methods A total of 195 children with RMPP who were admitted to Hebei Children′s Hospital from December 2020 to December 2022 were selected as the research objects.They were divided into control group,intervention group(course of disease≥14 d was classified as late intervention group and course of disease<14 d was classified as early intervention group)by random number table method,with 65 cases in each group.According to the clinical efficacy,130 patients who received bronchoscopic interventional therapy were divided into the effective group and the ineffective group.The control group was treated with routine treatment,and the late intervention group and early intervention group were treated with bronchoscopic intervention on the basis of the control group.The clinical efficacy,improvement of clinical symptoms and signs were compared among the control group,late intervention group and early intervention group.The levels of CRP,SF,IL-8 and CD4^(+)/CD8^(+)ratio in peripheral blood were detected and compared among the control group,late intervention group and early intervention group.The incidence rate of adverse reactions of the control group,late intervention group and early intervention group were compared.The levels of CRP,SF,IL-8 and CD4^(+)/CD8^(+)ratio in peripheral blood were compared between the effective group and the ineffective group.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of CRP,SF,IL-8 and CD4^(+)/CD8^(+)ratio in peripheral blood for the efficacy of bronchoscopic interventional therapy for RMPP.Results The total effective rate of the early intervention group was higher than that of the control group and the late intervention group,and the differences were statistically signifi

关 键 词：支气管镜介入治疗 儿童 难治性肺炎支原体肺炎 治疗时机 C反应蛋白 铁蛋白 白细胞介素-8 

分 类 号：R725.6[医药卫生—儿科] R446.1[医药卫生—临床医学]