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目的:探讨甘利欣联合阿奇霉素治疗对支原体肺炎伴急性肝功能损害患儿血清炎症因子、Ⅱ型肺泡表面抗原-6(KL-6)及核因子-κB(NF-κB)水平的影响。方法:选取86例支原体肺炎伴急性肝功能损害患儿为受试对象,随机数字表法分成研究组和对照组各43例。对照组中途脱落1例,共42例有效病例入组,予以常规对症治疗+阿奇霉素疗法;研究组中途脱落3例,共40例有效病例入组,在对照组治疗基础上联合甘利欣静脉滴注疗法。观察对比两组受试患儿治疗前后血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-12(IL-12)及肿瘤坏死因子-α(TNF-α)]、血清KL-6、血清NF-κB、肝功能指标[血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]变化情况,记录其发热、咳嗽、肺部湿罗音等消失时间差异。结果:治疗4w后,两组患儿IL-6[(44.5±6.2)pg/m L vs(60.3±6.6)pg/m L]、IL-12[(42.4±6.2)pg/m L vs(52.1±6.8)pg/m L]、TNF-α[(128.6±44.8)ng/L vs(201.4±51.8)ng/L]等血清炎症因子检测结果、ALT[(46.8±9.5)U/I vs(83.6±9.8)U/I]、AST[(62.2±10.1)U/I vs(84.8±10.2)U/I]、TBIL[(38.2±8.5)μmol/L vs(49.3±9.0)μmol/L]等肝功能指标检测结果及血清KL-6[(5.9±0.6)pg/m L vs(6.5±0.7)pg/m L]、NF-κB[(7.8±0.4)pg/m L vs(8.1±0.3)pg/m L]水平均较治疗前显著降低,且研究组小于对照组,差异有统计学意义(P<0.05)。研究组患儿治疗后发热、咳嗽、肺部湿罗音等消失时间均显著短于对照组患儿,差异有统计学意义(P<0.05)。结论:甘利欣联合阿奇霉素疗法可在促进支原体肺炎伴急性肝功能损害患儿病情转归、改善其血清炎症因子、调节肺功能、肝功能状态等方面发挥积极作用。
Objective: To investigate the effects of combination of Ganlixin and azithromycin on the levels of serum inflammatory cytokines, type Ⅱ alveolar surface antigen-6 (KL-6) and nuclear factor-κB (NF-κB) in children with mycoplasma pneumonia and acute liver dysfunction. Methods: Totally 86 children with mycoplasma pneumonia and acute liver dysfunction were enrolled in this study. The patients were randomly divided into study group and control group with 43 cases in each group. One case of the control group shedding in the middle, a total of 42 cases were enrolled in the group, to be conventional symptomatic treatment + azithromycin therapy; study group 3 cases off-course, a total of 40 cases were enrolled in the control group based on the combination of Gan Li Xin intravenous infusion therapy. The levels of serum inflammatory cytokines (IL-6, IL-12 and TNF-α), serum KL -6, serum NF-κB, liver function indicators (serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL)] changes were recorded fever, cough , Lung wet rales disappear time difference. RESULTS: After 4 weeks of treatment, IL-6 [(44.5 ± 6.2) pg / m L vs (60.3 ± 6.6) pg / m L] 52.1 ± 6.8 pg / m L] and TNF-α [(128.6 ± 44.8) ng / L vs (201.4 ± 51.8) ng / L] (83.6 ± 9.8) U / I, AST [(62.2 ± 10.1) U / I vs (84.8 ± 10.2) U / I] and TBIL [(38.2 ± 8.5) μmol / L vs 49.3 ± 9.0 μmol / L ] And other liver function test results and serum levels of KL-6 [(5.9 ± 0.6) pg / m L vs (6.5 ± 0.7) pg / m L) ± 0.3) pg / m L] were significantly lower than before treatment, and the study group was smaller than the control group, the difference was statistically significant (P <0.05). The disappearance time of fever, cough and wet rales of lung in study group were significantly shorter than those in control group after treatment (P <0.05). Conclusion: The combination of Ganamixin and azithromycin can play a positive role in promoting the prognosis of children with mycoplasma pneumonia and acute liver dysfunction, improving serum inflammatory cytokines, regulating lung function and liver function status.