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目的考察小儿支原体肺炎血锌含量变化及应用补锌制剂治疗对疾病的影响。方法检测2014年3月至2015年2月60例小儿支原体肺炎患儿和同期30例健康儿童(健康组)的血锌水平,将60例小儿支原体肺炎患儿随机分为补锌组和不补锌组,每组30例。不补锌组患儿给予罗红霉素和其他支持治疗,补锌组患儿在此基础上给予葡萄糖酸锌治疗,比较三组对象的血锌水平,比较补锌和不补锌组血锌水平的变化及临床疗效、临床症状消失时间和血清免疫球蛋白水平。结果治疗前补锌组和不补锌组患儿血锌水平低于健康组(P<0.01)。治疗后补锌组和不补锌组血锌水平高于治疗前(P<0.05,P<0.01),且补锌组达健康组血锌水平而高于不补锌组(P<0.01)。补锌组临床治疗有效率为96.7%,显著优于不补锌组的80.0%(χ~2=4.043,P<0.05)。补锌组患儿咳嗽消失时间、肺部罗音消失时间、X线片阴影吸收消失时间均显著短于不补锌组(P均<0.01)。补锌组患儿治疗后IgM和IgG水平显著高于不补锌组(P<0.05,P<0.01),IgA水平亦高于不补锌组,但差异无统计学意义。结论小儿支原体肺炎患儿血锌含量偏低,通过应用补锌制剂辅助治疗可以改善免疫功能进而改善临床治疗效果。
Objective To investigate the changes of blood zinc levels in children with mycoplasma pneumonia and the effects of zinc supplementation on the disease. Methods From March 2014 to February 2015, 60 cases of children with mycoplasma pneumonia and 30 healthy children (healthy group) were enrolled in this study. The serum levels of zinc in 60 children with mycoplasmal pneumonia were randomly divided into zinc supplementation group and non-supplementation group Zinc group, 30 cases in each group. Roxithromycin and other supportive treatment were given to children without zinc supplementation. Children with zinc supplementation were treated with zinc gluconate on the basis of this study. Blood zinc levels of the three groups were compared. Level changes and clinical efficacy, disappearance of clinical symptoms and serum immunoglobulin levels. Results Before treatment, children with and without zinc supplementation had lower levels of zinc in blood than those in healthy controls (P <0.01). The levels of serum zinc in the zinc-supplemented and non-supplemented zinc-treated groups were higher than those before treatment (P <0.05, P <0.01), and the levels of zinc in the zinc-supplemented group were higher than those in the zinc-supplemented group (P <0.01). The effective rate of clinical treatment in zinc supplementation group was 96.7%, significantly higher than 80.0% in non-supplemented zinc group (χ ~ 2 = 4.043, P <0.05). Zinc group children cough disappear time, pulmonary rales disappeared time, X-ray film shadow absorption disappeared significantly shorter than the non-zinc group (P all <0.01). The levels of IgM and IgG in the zinc supplementation group were significantly higher than those in the zinc supplementation group (P <0.05, P <0.01), and IgA levels were higher than those in the zinc supplementation group, but the difference was not statistically significant. Conclusion Children with mycoplasma pneumonia have low serum zinc levels. The adjuvant treatment with zinc supplementation can improve the immune function and improve the clinical therapeutic effect.