免疫球蛋白联合美罗培南治疗新生儿败血症的疗效及对细胞因子和免疫功能的影响  

Efficacy of immunoglobulin combined with meropenem in the treatment of neonatal sepsis and its impact on cytokines and immune function

作　　者：朱剑越 肖佳荔 ZHU Jianyue;XIAO Jiali(Department of Neonatology,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市妇幼保健院新生儿科,314000

出　　处：《浙江医学》2025年第5期524-527,共4页Zhejiang Medical Journal

摘　　要：目的探讨使用免疫球蛋白(Ig)联合美罗培南治疗新生儿败血症的疗效及对细胞因子和免疫功能的影响。方法回顾性选择2022年6月至2024年6月嘉兴市妇幼保健院收治的新生儿败血症患儿98例,依据随机数字表法分为观察组(49例)与对照组(49例)。对照组静脉滴注美罗培南,观察组在美罗培南基础上加用Ig静脉滴注。两组均治疗7 d。比较两组患儿治疗疗效和症状消失时间;治疗前后降钙素原(PCT)、C反应蛋白(CRP)、细胞因子和免疫功能指标水平变化。结果观察组患儿总有效率(93.88%)高于对照组(77.55%)(P<0.05)。观察组患儿体温恢复正常时间、皮肤颜色恢复正常时间和拒奶改善时间均短于对照组(均P<0.001)。两组患儿治疗后PCT和CRP水平均低于治疗前(均P<0.001);观察组治疗后PCT和CRP水平均低于对照组(均P<0.001)。两组治疗后白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均低于治疗前(均P<0.001);观察组治疗后IL-6和TNF-α水平均低于对照组(均P<0.001)。两组治疗后IgA、IgG和IgM水平均高于治疗前(均P<0.001);观察组治疗后患儿IgA、IgG和IgM水平均高于对照组(均P<0.001)。结论Ig联合美罗培南治疗新生儿败血症疗效显著,且可减轻患儿细胞炎症反应,提高患儿免疫功能,值得临床借鉴。Objective To explore the efficacy of using immunoglobulin(Ig)combined with meropenem in the treatment of neonatal sepsis and its impact on cytokines and immune function.Methods The 98 cases of neonatal sepsis admitted to Jiaxing Maternal and Child Health Hospital from June 2022 to June 2024 were retrospectively selected and randomly divided into an observation group(49 cases)and a control group(49 cases)using a random number table method.The control group received intravenous infusion of meropenem,while the observation group received intravenous Ig infusion on the basis of meropenem respectively.Both groups were treated for 7 days.The treatment efficacy and symptom disappearance time were compared between the two groups of children with sepsis;Changes in procalcitonin(PCT)and C-reactive protein(CRP)levels,cytokines,and immune function indicators were also compared before and after treatment.Results The observation group showed a higher total effective rate(93.88%)than that of the control group(77.55%)(P<0.05).The time to recovering normal body temperature,time to returning normal skin color,and the time to improvement of milk refusal in the observation group were all shorter than those of the control group(all P<0.001).After treatment,the levels of PCT and CRP in two groups of patients were lower than the same group before treatment(both P<0.001),with their post-treatment levels in the observation group lower than those of the control group(both P<0.001).After treatment,the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in two groups were both lower when comparing with those in the same group before treatment(both P<0.001);The post-treatment average levels of IL-6 and TNF-αin the observation group were lower than those of the control group(both P<0.001).After treatment,the levels of IgA,IgG,and IgM in both groups were all higher than those before treatment(all P<0.001);After treatment,the levels of IgA,IgG,and IgM in the observation group were higher than those of the control group(all P<0.001)

关 键 词：免疫球蛋白 美罗培南 新生儿败血症 疗效 细胞因子 免疫功能 

分 类 号：R72[医药卫生—儿科]