【摘要】 目的:探究肾上腺皮质激素联合头孢呋辛治疗重症肺炎患儿的效果及对免疫功能的影响。方法:将我院2015年1月至2017年12月收治的180例重症肺炎患儿,按照简单随机分组法分为观察组(n=90)与对照组(n=90),两组均给予祛痰、平喘、止咳等常规对症治疗,对照组每日静脉滴注头孢呋辛,观察组联合甲泼尼龙静脉滴注,比较两组临床疗效、炎症因子水平[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及免疫功能指标,并记录两组退热、肺啰音消失症状改善时间及ICU住院时间、总住院时间与治疗过程中的不良反应。结果:观察组疗效总有效率88.89%(80/90)显著高于对照组77.78%(70/90),差异有统计学意义(P<0.05);治疗后观察组IL-10、CD3+、CD4+、CD4+/CD8+水平显著高于对照组,IL-6、TNF-α、CRP及CD8+水平显著低于对照组,观察组退热时间、肺啰音消失时间显著早于对照组,ICU住院时间及总住院时间显著短于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率5.56%(5/90)略低于对照组12.22%(11/90),但差异无统计学意义(P>0.05)。结论:肾上腺皮质激素联合头孢呋辛治疗重症肺炎患儿的临床疗效确切,可显著改善患儿炎症反应及临床症状,提高机体免疫功能,缩短住院时间,具有较高安全性。更多还原

【Abstract】 Objective: To explore the therapeutic effect of adrenal cortex hormones combined with cefuroxime in children with severe pneumonia and its effects on immune function. Methods: 180 cases of children with severe pneumonia admitted to our hospital from January 2015 to December 2017 were divided into the observation group(n=90) and the control group(n=90) according to the simple random grouping method. The two groups were given the removing phlegm, relieving asthma and cough and other conventional symptomatic treatment, and the control group was given the daily intravenous drop of cefuroxime, and the observation group was additionally given the intravenous drop of methylprednisolone. The clinical efficacy, the inflammatory factors levels [interleukin-6(IL-6), interleukin-10(IL-10), tumor necrosis factor α(TNF-α), C-reactive protein(CRP)] and immune function indexes were compared between the two groups. And the improvement time of antipyretic and pulmonary rales disappearance symptoms, and the ICU stay, total hospital stay and adverse reactions during treatment were recorded in the two groups. Results: The total effective rate of efficacy in the observation group was significantly higher than that in the control group [88.89%(80/90) vs 77.78%(70/90)](P<0.05). After treatment, the levels of IL-10, CD3+, CD4+ and CD4+/CD8+ in the observation group were significantly higher than those in the control group, and the levels of IL-6, TNF-α, CRP and CD8+ were significantly lower than those in the control group, and the antipyretic time and the pulmonary rales disappearance time were significantly earlier than those in the control group, and the ICU stay and total hospital stay were significantly shorter than those in the control group(P<0.05). The incidence rate of adverse reactions in the observation group was slightly lower than that in the control group [5.56%(5/90) vs 12.22%(11/90) ](P>0.05). Conclusion: Adrenal cortex hormones combined with cefuroxime can have an exact clinical efficacy in children with severe pneumonia, and it can significantly improve the inflammatory reactions and clinical symptoms, enhance the immune function and shorten the hospital stay, and it has high safety.更多还原