糖皮质激素联合纤维支气管镜灌洗对大叶性肺炎患儿炎症反应的影响

目的:探讨糖皮质激素联合纤维支气管镜灌洗治疗肺炎支原体大叶性肺炎的可行性、有效性与安全性,并分析其对患儿炎症反应的影响。方法:选取2016 年3 月至2018 年3月郑州市金水区总医院确诊为肺炎支原体感染引起的大叶性肺炎患儿68 例,按随机数表法分为研究组与对照组各34 例。对照组患儿给予糖皮质激素治疗,研究组给予糖皮质激素联合纤维支气管镜灌洗治疗,治疗7 ~10 d 后,观察两组患儿治疗效果、治疗期间不良反应发生情况,分别于治疗前后检测两组患儿炎症反应指标及肺功能。结果:研究组治疗效果优于对照组,各临床症状及体征缓解或消失时间均短于对照组,差异有统计学意义( P<0.05)。两组患儿治疗期间无不良反应发生。治疗后研究组血清白细胞介素-2(IL-2) 水平高于对照组,白细胞介素-6( IL-6)、C 反应蛋白(CRP)、血沉(ESR)水平均低于对照组,差异有统计学意义(P<0.05)。治疗后研究组肺功能( 包括大气道通气功 能、小气道通气功能)较对照组均明显改善,差异有统计学意义(P<0.05)。结论:糖皮质激素联合纤维支气管镜灌洗治疗肺炎支原体大叶性肺炎患儿有利于增强治疗效果,缓解患儿临床症状及体征,缩短疗程,有效减轻炎症反应,显著改善肺功能,且无不良反应,安全有效。

Effects of Glucocorticoid Combined with Fiberoptic Bronchoscopy Lavage on Inflammatory Response in Children with Lobar Pneumonia

Objective: To probe into the feasibility, effectiveness and safety of glucocorticoid combined with fiberoptic bronchoscopy lavage on inflammatory response in children with lobar pneumonia, so as to analyze its effects on inflammatory response of children.Methods: Totally 68 children with lobar pneumonia caused by Mycoplasma pneumoniae infection admitted into our hospital from Mar.2016 to Mar. 2018 were selected to be divided into the study group and the control group via the random number table, with 34 cases in each group. Patients in the control group were treated with glucocorticoid, while those in the study group were treated with glucocorticoid combined with fiberoptic bronchoscopy lavage. After treatment of 7 to 10 d, the therapeutic effects and adverse drug reactions in two groups were observed, and the index of inflammatory response and lung function in two groups were detected before and after treatment.Results: The therapeutic effects of the study group were better than those of the control group, and the disappearance time of all clinical symptoms and signs was shorter than that of the control group, with statistically significant difference (P<0.05). There were no adverse drug reactions in two groups during treatment. After treatment, the serum interleukin-2 (IL-2) level in the study group was higher than that in the control group, and the levels of interleukin-6 (IL-6), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). After treatment, the lung function (including atmospheric airway ventilation function and small airway ventilation function) in the study group had been significantly improved compared with the control group, with statistically significant difference (P<0.05). Conclusion: Glucocorticoid combined with fiberoptic bronchoscopy lavage in the treatment of children with lobar pneumonia caused by Mycoplasma pneumoniae can enhance the curative effects, relieve the clinical symptoms and signs, shorten the course of treatment, reduce the inflammatory response,improve the pulmonary function and have no adverse drug reactions with higher safety.