摘要
目的 分析复方鲜竹沥液联合支气管肺泡灌洗术(BAL)治疗儿童重症肺炎支原体(MP)感染性大叶性肺炎的临床疗效,以及对患儿免疫炎症状态的影响,为临床提供参考依据。方法 选取2022年1月至2024年1月收治的104例重症MP感染性大叶性肺炎患儿,按随机数字表法平均分为两组。对照组接受BAL治疗,在此基础上观察组联合复方鲜竹沥液治疗。连续治疗2周后评价两组临床疗效。比较两组治疗前后主要症状积分、肺炎胸片吸收评价量表(PCRAES)、临床肺部感染评分(CPIS),以及免疫炎症指标[补体C3、C4、CD3*人类白细胞抗原-DR(CD3*HLA-DR)、自然杀伤细胞(NK细胞)、血清淀粉样蛋白A(SAA)、白细胞介素(IL)-33、可溶性细胞间黏附分子-1(sICAM-1)]水平。统计两组不良反应情况。结果 总有效率:观察组[94.23%(49/52)]高于对照组[80.77%(42/52),P<0.05]。两组主要症状(发热、咳嗽、痰量、痰液性质、胸痛、肺部啰音)积分比较,治疗后均低于同组治疗前(P<0.05),且治疗后观察组低于对照组(P<0.05)。治疗后,两组PCRAES、CPIS评分和血清补体C3、C4、SAA、IL-33、sICAM-1水平均显著降低(P<0.05),外周血CD3*HLA-DR、NK细胞水平均显著升高(P<0.05),以观察组为甚(P<0.05)。观察组不良反应率[7.69%(4/52)]较对照组[5.77%(3/52)],差异无统计学意义(P>0.05)。结论 在BAL基础上联合复方鲜竹沥液治疗能有效提高儿童重症MP感染性大叶性肺炎的临床疗效,能更好地促进患儿症状改善及肺部感染减轻,其作用可能与进一步纠正机体免疫功能紊乱、抑制炎症反应有关。
Objective To analyze the clinical efficacy of Compound Fresh Bamboo Leach combined with bronchoalveolar lavage(BAL)in treating severe mycoplasma pneumoniae(MP)lobar pneumonia in children and its impact on immune-inflammatory status.MethodssA total of 104 children with severe MP lobar pneumonia admitted from January 2022 to January 2024 were randomly divided into two equal groups.The control group received BAL treatment,while the observation group received additional Compound Fresh Bamboo Leach.After two weeks of treatment,clinical efficacy was evaluated.The two groups were compared in terms of major symptom scores,pneumonia chest X-ray absorption evaluation scale(PCRAES),clinical pulmonary infection score(CPIS),and immune-inflammatory indicators,including complement C3,C4,CD3*human leukocyte antigen-DR(CD3*HLA-DR),natural killer(NK)cells,serum amyloid A(SAA),interleukin-33(IL-33),and soluble intercellular adhesion molecule-1(sICAM-1).Adverse reactions were recorded.Results The total effective rate was significantly higher in the observation group(94.23%,49/52)than in the control group(80.77%,42/52)(P<0.05).Symptom scores(fever,cough,sputum volume,sputum properties,chest pain,lung rales)decreased significantly after treatment in both groups(P<0.05)and were significantly lower in the observation group than in the control group after treatment(P<0.05).Post-treatment,PCRAES,CPIS,and serum levels of C3,C4,SAA,IL-33,and sICAM-1 were significantly reduced in both groups(P<0.05),while peripheral blood CD3*HLA-DR and NK cell levels were significantly increased(P<0.05),with a more pronounced effect in the observation group(P<0.05).The incidence of adverse reactions was 7.69%(4/52)in the observation group and 5.77%(3/52)in the control group,with no significant difference between the two(P>0.05).Conclusion The combination of compound fresh bamboo leach with BAL significantly improves the clinical efficacy of treating severe MP lobar pneumonia in children,enhances symptom relief,and reduces pulmonary infection.Its mechanism may be related to better immune function regulation and inhibition of inflammatory responses.
作者
刘冬梅
王敬敏
徐琳
王亚楠
侯秀玲
LU Dong-mei;WANG Jing-min;XU Lin;WANG Ya-nan;HOU Xiu-ling(Department of Pediatrics,Baoding Second Central Hospital,Baoding 072750,Hlebei,China)
出处
《广东医学》
2025年第5期641-647,共7页
Guangdong Medical Journal
基金
河北省医学科学研究重点课题计划(20181791)。
关键词
儿童
免疫炎症反应
重症肺炎
复方鲜竹沥液
肺炎支原体
支气管肺泡灌洗术
大叶性肺炎
children
immunoinflammatory response
severe pneumonia
Fresh Bamboo Leach Compound
mycoplasma pneumoniae
bronchoalveolar lavage
lobar pneumonia
