不同剂量免疫球蛋白辅助治疗新生儿感染性肺炎疗效及对免疫功能、心肌酶指标影响  

Efficacy of the different doses of immunoglobulin in the adjuvant therapy of the neonatal infectious pneumonia and its influence on the immune function and myocardial enzyme indicators

作　　者：李莉[1] 李爱民 罗寒衣 LI Li;LI Aimin;LUO Hanyi(Maternal and Child Health Care Hospital of Guangyuan,Guangyuan,Sichuan Province,628017)

机构地区：[1]四川省广元市妇幼保健院,628017

出　　处：《中国计划生育学杂志》2025年第4期840-844,850,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨新生儿感染肺炎使用不同剂量免疫球蛋白进行辅助治疗对患儿心肌酶指标和免疫功能的影响。方法:回顾性分析本院2021年5月-2024年5月收治的新生儿肺炎感染者287例,根据患儿治疗方法分为基础治疗组(n=89)、基础治疗联合免疫球蛋白辅助治疗的低剂量组(400 mg/kg/d,n=98)和高剂量组(1000 mg/kg/d,n=100),均治疗5 d,比较3组临床疗效、症状缓解时间、炎症指标、免疫功能、心肌酶指标。结果:治疗后24h,治疗有效率高剂量组(96.0%)高于低剂量组(87.8%)和对照组(78.7%);对照组、低剂量组、高剂量组喘憋缓解时间、退热时间、咳嗽改善时间、哮鸣音消失时间依次缩短,炎症指标TNF-α、CRP、IL-6水平依次降低,免疫功能指标CD4~+和CD4~+/CD8~+水平依次升高,CD8~+水平依次降低,心肌酶指标(AST、CK、CK-MB、LDH)水平依次升高(均P<0.05)。结论:新生儿感染性肺炎使用高剂量免疫球蛋白辅助治疗可有效降低患儿炎症水平,缩短症状缓解时间,提升免疫功能,降低心肌酶指标水平。Objective:To explore the influence of the adjuvant therapy with different doses of immunoglobulin for neonatal infectious pneumonia on the myocardial enzyme indicators and immune function of the neonates.Methods:A retrospective analysis was performed on 287 neonates with pneumonia infection in the hospital from May 2021 to May 2024.According to the treatment methods,the neonates were divided into group C(89 neonates with basic treatment),group B(98 neonates with basic treatment combined with 400 mg/kg/d low-dose immunoglobulin adjuvant therapy)and group A(100 neonates with basic treatment combined with 1000 mg/kg/d high-dose immunoglobulin adjuvant therapy).The clinical efficacy,the symptom relief time,and the levels of the inflammatory indicators,immune function and myocardial enzyme indicators of the neonates were compared among the three groups.Results:In 24 hour after treatment,the effective rate(96.0%)of the neonates in group A was significantly higher than that(87.8%)of the neonates in group B and that(78.7%)of the neonates in group C.The asthma relief time,the antipyretic time,the cough improvement time,the wheezing rale disappeared time of the neonates in group C,in group B and in group A had shortened gradually.The levels of the inflammatory indicators,such as TNF-α,CRP and IL-6,of the neonates in group C,in group B and in group A had decreased gradually.The immune function indicators,such as CD4~+level and CD4~+/CD8~+ration of the neonates in group C,in group B and in group A had increased gradually.The level of CD8~+of the neonates in group C,in group B and in group A had decreased gradually.The levels of myocardial enzymes,such as AST,CK,CK-MB and LDH,of the neonates in group C,in group B and in group A had increased gradually(all P<0.05).Conclusion:The application of the high-dose immunoglobulin adjuvant therapy for the neonatal infectious pneumonia can effectively reduce the inflammation level,shorten the symptom relief time,enhance the immune function and reduce the levels of myocardial enzyme ind

关 键 词：新生儿感染性肺炎 免疫球蛋白 辅助治疗 免疫功能 心肌酶指标 炎症指标 

分 类 号：R722.1[医药卫生—儿科]