摘要
目的:探讨纤维支气管镜下敏感抗生素肺泡灌洗对重症肺炎患儿血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)的表达及临床意义。方法:选取2017年7月至2019年1月广西医科大学第十附属医院收治的重症肺炎患儿60例,随机分为观察组和对照组,每组30例。对照组采用常规抗生素治疗方式,观察组在对照组基础上进行纤维支气管镜肺泡灌洗治疗。比较两组治疗前、后血清MMP-9、TIMP-1水平、痰检阳性率、肺功能及不良反应发生情况。结果:治疗后,观察组MMP-9、TIMP-1水平和MMP-9/TIMP-1比值分别为(137.51±38.42)ng/mL、(120.46±36.34)ng/mL和1.07±0.38,均显著低于对照组的(172.42±40.50)ng/mL、(139.52±38.32)ng/mL和1.32±0.42(均P<0.05);治疗后,观察组肺功能参数达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)和潮气量(VT)分别为(31.09±5.48)%、(30.21±6.87)%和(7.63±1.31)m L/kg,均明显高于对照组的(21.43±5.32)%、(22.27±6.54)%和(6.65±1.42)mL/kg(均P<0.05);观察组痰检阳性率为26.67%,显著低于对照组的46.67%(均P<0.05);观察组总有效率为93.33%,高于对照组的76.67%(P<0.05);两组均未出现严重的不良反应。结论:纤维支气管镜下敏感抗生素肺泡灌洗治疗重症肺炎患儿疗效显著,能够显著降低血清中MMP-9、TIMP-1水平,缓解炎症损伤,改善呼吸困难,具有较高的临床应用价值。
Objective: To investigate the expression and clinical significance of serum matrix metalloproteinase-9(MMP-9)and matrix metalloproteinase inhibitor-1(TIMP-1)in children with severe pneumonia after bronchoalveolar lavage with sensitive antibiotics under fiber bronchoscope.Methods: Sixty children with severe pneumonia who were admitted in the first people’s Hospital of Qinzhou from July 2017 to January 2019 were randomly divided into observation group and control group,with 30 cases in each group.Patients in the control group were treated with routine antibiotics,and patients in the observation group were treated with bronchoalveolar lavage with fiber bronchoscope on the basis of the control group.The levels of serum MMP-9 and TIMP-1,the positive rate of sputum examination,lung function,and adverse reactions were compared between the two groups before and after treatment.Results: After treatment,the levels of MMP-9,TIMP-1,and the ratio of MMP-9/TIMP-1 in the observation group were(137.51±38.42)ng/mL,(120.46±36.34)ng/mL and 1.07±0.38 respectively,which were significantly lower than those in the control group(172.42±40.50)ng/mL,(139.52±38.32)ng/mL and 1.32±0.42(all P<0.05).After treatment,the peak time ratio(TPTEF/TE),peak volume ratio(VPTEF/VE),and tidal volume(VT)of lung function parameters in the observation group were(31.09±5.48)%,(30.21±6.87)% and(7.63±1.31)mL/kg respectively,which were significantly higher than those in the control group(21.43±5.32)%,(22.27±6.54)% and(6.65±1.42)mL/kg,respectively(all P<0.05).The positive rate of sputum examination in the observation group was26.67%,which was significantly lower than that in the control group(46.67%)(all P<0.05).The total effective rate in the observation group was 93.33%,which was higher than that in the control group(76.67%)(P<0.05).There were no serious adverse reactions in both groups.Conclusion: Bronchoalveolar lavage with sensitive antibiotics under fiber bronchoscope is effective in the treatment of children with severe pneumonia,which can significantly reduce the levels of MMP-9 and TIMP-1 in serum,relieve inflammatory injury and improve dyspnea.It is worthy for clinical popularization.
作者
黄莹萱
丁敏才
敖超
Huang Yingxuan;Ding Mincai;Ao Chao(Department of pediatrics,The 10th Affiliated Hospital of Guangxi Medical University,Qinzhou 535000,China;Department of pediatrics,Qinzhou Maternal and Child Health Hospital,Qinzhou 535000,China)
出处
《广西医科大学学报》
CAS
2020年第4期746-750,共5页
Journal of Guangxi Medical University
