匹多莫德佐治小儿抗生素相关性腹泻的临床疗效及对其免疫功能的影响

目的：观察匹多莫德佐治小儿抗生素相关性腹泻的临床疗效及对其免疫功能的影响,为临床治疗提供理论依据。方法：选取本院2011-2013年收治的100例小儿抗生素相关性腹泻患儿作为观察对象,按治疗方法分为观察组50例和对照组50例。对照组给予常规方法治疗,包括抗炎、止泻、微生态制剂（复方嗜酸乳杆菌）、营养支持等对症治疗,观察组在对照组治疗的基础上再给予匹多莫德口服液每次400 mg,每天2次,两组疗程均为14 d;治疗前后空腹抽血,采用流式细胞仪检测患儿外周血T细胞亚群（CD3^＋、CD4^＋、CD8^＋、CD4^＋/CD8^＋）变化情况,采用单向琼脂扩散法检测治疗前后患儿血清免疫球蛋白水平（IgG、IgA、IgM）,评价两组患儿抗生素相关性腹泻的疗效及对免疫功能的影响,停药1周后观察疾病复发情况。结果：（1）观察组和对照组患儿腹泻、呕吐缓解及治愈时间分别为（2.1±1.5）d vs（5.4±2.2）d、（1.7±0.6）d vs（3.3±1.4）d、（9.1±1.6）d vs（11.7±1.6）d,两组比较差异均有统计学意义（t值分别为3.754、3.827、3.923,P均〈0.05）;（2）观察组临床总有效率（94.00%）明显高于对照组（76.00%）（χ2=9.836,P〈0.01）,观察组复发率（6.00%）显著低于对照组（20.00%）（χ2=4.332,P〈0.05）;（3）观察组和对照组治疗后血清免疫球蛋白IgG、IgA和T淋巴细胞亚群CD3^＋、CD4^＋、CD4^＋/CD8^＋水平较治疗前明显升高（P均〈0.05）。结论：小儿抗生素相关性腹泻在常规治疗基础上给予匹多莫德治疗,能够有助于重建肠道微生态系统平衡,抑制致病菌生长,增强患儿免疫功能,提高临床疗效,降低复发率,值得基层医院推广应用。

The Effect and Influence on Immune Function of Pidotimod in the Treatment of Children with AntibioticAssociated Diarrhea

Objective： To observe the effect and influence on immune function of pidotimod in the treatment of children with antibioticassociated diarrhea. Methods： One hundred children with antibiotic-associated diarrhea from 2011 to 2013 were randomly divided into50 cases of observation group and 50 cases of control group,both groups were given conventional therapy,including anti-inflammatory,diarrhea,probiotics（ compound lactobacillus acidophilus）,nutritional support and symptomatic treatment,the observation group was given pidotimod for 400 mg /times,bid,for 14 d,recorded diarrhea and vomiting remission time,fasting blood before and after treatment,T-cell subsets（ CD3^＋,CD4^＋,CD8^＋,CD4^＋/CD8^＋） were detected by flow cytometry and serum immunoglobulin（IgG,IgA,IgM） were detected by unidirectional agar diffusion method,evaluated the clinical efficacy,make a statistics of relapse rate after 1week. Results：（1） The time of diarrhea,vomiting and healing of observation group and control group were（2. 1 ± 1. 5） d vs（5. 4 ±2. 2）d,（1. 7 ± 0. 6）d vs（3. 3 ± 1. 4）d,（9. 1 ± 1. 6）d vs（11. 7 ± 1. 6）d,the index of observation group were significantly shorter than the control group（t = 3. 754,3. 827,3. 923,all P〈0. 05）;（2） The total clinical efficacy and relapse rate of observation group and control group were 94. 00% vs 76. 00%,6. 00% vs 20. 00%,the total effective of observation group were significantly higher than control group（χ2= 9. 836,P〈0. 01）,the relapse rate of observation group were significantly lower than the control group（χ2= 4. 332,P〈0. 05）;（3） The serum immunoglobulins IgG,IgA and T lymphocyte subsets CD3^＋,CD4^＋,CD4^＋/CD8^＋after treatment were significantly higher than before treatment,the serum immunoglobulins IgG,IgA and T lymphocyte subsets CD3^＋,CD4^＋,CD4^＋/CD8^＋of observation group were significantly higher than control group（ all P〈0. 05）. Conclusions： The method contained pidotimod can reconstructed the i