人免疫球蛋白联合机械通气对急性肺损伤患儿疗效研究

目的:观察静注人免疫球蛋白联合机械通气对急性肺损伤患儿疗效及肺功能和免疫功能的影响。方法:将106例急性肺损伤患儿随机分为两组,对照组53例给予机械通气治疗,研究组53例给予静注人免疫球蛋白联合机械通气治疗,两组均持续治疗2d。比较两组治疗后临床疗效,统计两组治疗前后急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、Murray肺损伤评分、动脉血气指标、氧合指数和免疫功能水平。结果:研究组治疗后临床总有效率86.79%显著优于对照组66.04%(P<0.05);研究组和对照组治疗后APACHEⅡ评分、Murray肺损伤评分、肺动脉血二氧化碳分压(PaCO2)、CD8^+T水平均较治疗前显著下降(P<0.05),且研究组治疗后上述指标均较对照组降低幅度更明显(P<0.05);研究组和对照组治疗后肺动脉血氧分压(PaO2)、氧合指数、CD3^+T、CD4^+T和CD4^+/CD8^+水平均较治疗前显著上升(P<0.05),且研究组治疗后上述指标均较对照组升高幅度更明显(P<0.05)。结论:静注人免疫球蛋白联合机械通气治疗急性肺损伤患儿,疗效确切,同时能明显改善肺功能和免疫功能。

Effect study of human immunoglobulin combined with mechanical ventilation on children with acute lung injury

Objective:To observe the effect of intravenous injection of human immunoglobulin combined with mechanical ventilation on lung function and immunologic function in children with acute lung injury.Methods:106 children with acute lung injury were divided into two groups randomly,53 cases in the control group were treated with mechanical ventilation,and 53 cases in the research group were treated with human immunoglobulin for intravenous injection combined with mechanical ventilation,and the two groups were treated with continuous treatment for 2 d.The clinical efficacy after treatment of the two groups was compared.The scores of acute physiology and chronic health status of the two groups before and after treatmentⅡ(APACHEⅡ),Murray lung injury score,arterial blood gas index,oxygenation index and immune function level were compared.Results:The total effective rate of the research group after treatment was 86.79%,which was significantly better than 66.04%of the control group(P<0.05).In the research group and the control group,the APACHEⅡscore,the Murray lung injury score,the pulmonary arterial blood carbon dioxide pressure(PaCO 2)and the CD8^+T level were significantly lower than those before the treatment(P<0.05),and the above indexes in the research group were significantly lower than those in the control group(P<0.05).After treatment,the levels of pulmonary arterial oxygen pressure(PaO 2),oxygenation index,CD3^+T,CD4^+T and CD4^+/CD8^+in the research group and the control group were significantly higher than before the treatment(P<0.05),and the above indexes in the research group were significantly higher than those in the control group(P<0.05).Conclusion:The curative effect of intravenous injection of human immunoglobulin combined with mechanical ventilation in the treatment of acute lung injury in children is definite,and the combination treatment can significantly improve lung function and immunologic function.