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目的:探讨乌司他丁联合常规治疗治疗对婴幼儿重症肺炎外周血APC、IL-1R1表达的影响。方法:选取2014年2月至2016年2月来四川省仁寿县人民医院进行治疗重症肺炎患儿120例,按照随机数字表法将其分为试验组和对照组。给予对照组患儿常规治疗,在常规治疗的基础上给予试验组患儿乌司他丁治疗。比较1个疗程后两组患儿的治疗有效率;对比两组患儿治疗前后免疫球蛋白水平;检测两组患儿治疗不同时间点外周血活化蛋白C(activated protein C,APC)和IL-1R1水平。结果:1个疗程后试验组患儿的治疗有效率显著高于对照组患儿(93.33%vs 76.67%,P<0.05)。治疗前两组患儿3种免疫球蛋白水平没有显著差异(P>0.05)1个疗程后对照组患儿IgA和IgM没有显著变化(P<0.05),但试验组患儿Ig G水平显著上升[(8.94±1.51 g·L~(-1))vs(12.15±0.92 g·L~(-1)),P<0.05]。治疗前患儿体内炎性因子水平没有显著差异(P>0.05);治疗3 d和5 d,试验组患儿APC水平更高且IL-1R1水平更低。结论:因乌司他丁可以有效缓解婴幼儿重症肺炎病情,调节患儿免疫系统功能,缓解炎性反应,值得临床推广。
Objective: To investigate the effects of ulinastatin combined with routine therapy on the expression of APC and IL-1R1 in infants with severe pneumonia. Methods: From February 2014 to February 2016, 120 patients with severe pneumonia were treated in Renshou County People’s Hospital of Sichuan Province. According to the random number table, they were divided into experimental group and control group. The control group of children given conventional treatment, given routine treatment of ulinastatin in children in the test group. The therapeutic efficacies of both groups were compared after one course of treatment. The levels of immunoglobulin in both groups were compared before and after treatment. The levels of activated protein C (APC) and IL- 1R1 level. Results: After 1 course of treatment, the treatment efficiency of the experimental group was significantly higher than that of the control group (93.33% vs 76.67%, P <0.05). There was no significant difference in the levels of IgA and IgM between the two groups before treatment (P> 0.05), but there was no significant change in IgA and IgM in the control group after one course of treatment (P <0.05) [(8.94 ± 1.51 g · L -1) vs (12.15 ± 0.92 g · L -1), P <0.05]. There was no significant difference in the level of inflammatory cytokines in children before treatment (P> 0.05). The levels of APC and IL-1R1 in the experimental group were higher on the 3rd and 5th day after treatment. Conclusion: Ulinastatin can effectively relieve the severe pneumonia in infants and young children, regulate the immune system and relieve the inflammatory reaction in children, which deserves clinical promotion.