肺泡灌洗术联合免疫球蛋白及甲强龙对重症支原体肺炎患儿的治疗评价

Treatment Evaluation of Alveolar Lavage Combined with Immunoglobulin and Methylprednisolone in Children with Severe Mycoplasmal Pneumonia

关键词:  肺泡灌洗技术  免疫球蛋白  甲强龙  重症支原体肺炎  肺功能  免疫功能  儿童

Key words:  bronchoalveolar lavage technique  immunoglobulin  methylprednisolone  severe mycoplasma pneumonia  pulmonary function  immune function  children

摘要:

目的 探究肺泡灌洗技术联合免疫球蛋白对重症支原体肺炎（severe mycoplasmal pneumonia，SMPP）患儿肺功能及免疫功能的影响。方法 将SMPP分为对照组和试验组，对照组给予小剂量甲强龙注射和人免疫球蛋白治疗，试验组在对照组治疗基础上给予肺泡灌洗。检测治疗前后2组SMPP的白细胞介素-2、白细胞介素-6和白细胞介素-10的水平；并在治疗后检测肺血管阻力（pulmonary vascular resistance，PVR）、肺毛细血管楔压（pulmonary capillary wedge pressure，PAWP）和平均肺动脉压（mean pulmonary artery pressure，mPAP）及T淋巴细胞亚群中CD4+、CD8+百分比。结果 治疗后2组SMPP肺功能免疫功能均明显改善，试验组mPAP、PAWP、PVR表达均低于对照组（P<0.05），试验组CD4+、C1D8+、CD4/CD8表达高于对照组（P<0.05）。结论 肺泡灌洗技术联合免疫球蛋白及甲强龙可明显改善SMPP患儿炎症因子的表达，促进肺功能恢复，提高免疫功能。

Abstract:

OBJECTIVE To investigate the effects of alveolar lavage combined with immunoglobulin on lung function and immune function in children with severe mycoplasmal pneumonia(SMPP). METHODS Patients were divided into control group and experimental group. Patients in the control group were given small doses of methylprednisolone injection and human immunoglobulin therapy. Patients in the experimental group were given alveolar lavage on the basis of low-dose methylprednisolone and human immunoglobulin injection therapy. The levels of interleukin-2, interleukin-6, and interleukin-10 were measured before and after treatment; and pulmonary vascular resistance(PVR) after treatment, pulmonary capillary wedge pressure (PAWP), mean pulmonary artery pressure(mPAP) and percentage of CD4+, CD8+ in T lymphocyte subsets were measured. RESULTS After treatment, the lung function and immune function indexes of the two groups were significantly improved. The expressions of mPAP, PAWP and PVR in the experimental group were lower than those in the control group(P<0.05). The expression of CD4+, C1D8+ and CD4/CD8 in the experimental group was higher than that in the control group(P<0.05). CONCLUSION Alveolar lavage combined with immunoglobulin and methylprednisolone can significantly improve the expression of inflammatory factors in children with severe mycoplasmal pneumonia, promote the recovery of lung function and improve immune function.