糖皮质激素对重症肺炎支原体肺炎患儿免疫功能的影响

目的观察糖皮质激素辅助治疗小儿重症肺炎支原体肺炎(RMPP)的临床疗效及对免疫功能的影响。方法将2005年1月至2010年1月来湘潭县人民医院进行住院治疗的80例RMPP患儿按照治疗药物不同分为治疗组和对照组各40例,两组均给予阿奇霉素进行治疗,其中治疗组在此基础上给予量糖皮质激素进行治疗。结果两组治疗效果比较差异无统计学意义(P>0.05),治疗组与对照组患者发热消失时间[(2.16±0.74)d vs(4.54±0.97)d],咳嗽消失时间[(7.78±2.86)d vs(11.16±3.90)d],肺部啰音消失时间[(5.64±1.75)d vs(9.03±1.86)d]及住院时间[(8.67±1.79)d vs(17.03±3.86)d],差异均有统计学意义(P<0.01),治疗组与对照组CD3+[(47.86±6.39)%vs(35.64±4.85)%]CD4+[(31.86±9.49)%vs(28.76±8.86)%]和CD4+/CD8+[(1.88±0.97)%vs(1.34±0.56)%]水平差异均有统计学意义,CD8+[(17.63±7.86)%vs(29.62±8.64)%],差异均有统计学意义(P<0.01)。结论糖皮质激素辅助治疗小儿RMPP,可有效调节RMPP紊乱的免疫功能,提高疗效,是治疗小儿RMPP的理想药物。

Study on the Effect of Glucocorticoid on the Immune Function of Children with Refractory Mycoplasma Pneumoniae Pneumonia

Objective To observe the effect of glucocorticoid in the adjuvant treatment for refractory mycoplasma pneumoniae pneumonia（RMPP） among children,and its impact on the imnmne function. Methods A total of 80 cases of children with RMPP admitted in People＇s Hospital of Xiangtan County from Jan. 2005 to Jan. 2010 were divided into treatment group and control group according to random number table, with 40 cases in each group. Children in both groups were given azithromycin treatment, and children in treatment group were given extra small doses of glucocortieoid. Results There was no statistically significant difference of treatment effectiveness between the two groups （ P 〉 0.05 ）. The fever disappearance time of treatment group and control group was[ （2.16 ± 0.74 ） d vs（4.54 ±0.97 ） d] , cough disappearance time was[ （7.78 ± 2.86） d vs （ 11.16 ± 3.90） d ], pulmonary tales disappeared time was [ （ 5.64 ± 1.75 ） d vs （9.03 ± 1.86 ） d ] and length of hospital stay was [ （ 8.67 ±1.79 ） d vs （ 17.03 ± 3.86 ） d ], the results showed all of the above time indicators of the treatment group were significantly lower than the control group, the differences were statistically significant（P 〈0.05） ;CD3＋ level and CD4＋/CD5＋ level of treatment group were significantly higher than the control group[ （47.86 ±6.39） % vs（35.64 ±4.85） % ], [ （ 1.88 ± 0.97 ） % vs（ 1.34± 0.56 ） % ], while CD8＋ level of treatment group was significantly lower than the control group [ （ 17.63 ± 7.86 ） % vs （ 29.62± 8.64 ） % ] ,the differences were statistically significant （ P 〈 0.01 ）. Conclusion Glucocorticoid in the adjuvant treatment for RMPP can effectively regulate disordered immune function,which can be an ideal drug in the treatment of children with RMPP.