| 摘要: |
| 目的：探讨地塞米松联合肺泡灌洗术治疗大叶性肺炎患儿的疗效及其对其血清可溶性细胞间黏附分子1（sICAM-1）、基质金属蛋白酶抑制因子1（TIMP-1）水平的影响。方法：选取2015年7月至2017年12月我院收治的104例大叶性肺炎患儿，按随机数字表法分为对照组和观察组各52例。两组患儿均采用常规治疗，包括去咳平喘、抗感染、退热等，对照组给予地塞米松治疗，观察组在对照组的基础上联合肺泡灌洗术治疗。比较两组患儿临床治疗效果、临床症状消失时间（咳嗽缓解时间、呼吸困难缓解时间、发热持续时间、肺部啰音消失时间、X片阴影消失时间）、住院时间，治疗前后炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素6（IL-6）、白细胞介素8（IL-8）]水平及血清sICAM-1、TIMP-1水平变化和不良反应发生情况。结果：观察组治疗总有效率94.23%，显著高于对照组的71.15%（P<0.01）；与对照组比较，观察组症状消失时间和住院时间均明显缩短（P<0.05）；治疗后，两组患儿炎症因子（TNF-α、IL-6、IL-8）水平较治疗前均显著降低，与对照组比较，观察组患儿炎症因子水平降低更为显著（P<0.01）；治疗后两组患儿血清sICAM-1、TIMP-1较治疗前均显著降低，与对照组比较，观察组降低更为显著（P<0.01）；两组患儿均未见地塞米松相关不良反应，观察组有5例发生纤维支气管镜肺泡灌洗术并发症，治疗结束后均缓解。结论：地塞米松联合肺泡灌洗术治疗大叶性肺炎效果显著，可明显降低炎症因子水平，改善血清sICAM-1、TIMP-1水平，减轻炎症反应，从而加快患儿症状的缓解，快速控制病情，缩短住院时间 |
| 关键词: 大叶性肺炎 地塞米松 纤维支气管镜肺泡灌洗术 基质金属蛋白酶抑制因子1 可溶性细胞间黏附分子1 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2020.03.008 |
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| 基金项目: |
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| Dexamethasone Combined with Alveolar Lavage in the Treatment of Children with Lobar Pneumonia and Its Effects on the Serum Soluble Intercellular Adhesion Molecule-1 and Tissue Inhibitors of Matrix Metalloproteinase-1 |
| Pang Hua |
| (Juye County People’s Hospital, Shandong Heze 274900, China) |
| Abstract: |
| Objective: To investigate the efficacy of dexamethasone combined with alveolar lavage in the treatment of children with lobar pneumonia and its effects on serum soluble intercellular adhesion molecule-1 (sICAM-1) and tissue inhibitors of matrix metalloproteinase-1 (TIMP-1) levels. Methods: Totally 104 children with lobar pneumonia admitted into our hospital fem Jul. 2015 to Dec. 2017 were extracted to be divided into the control group and the observation group via the random number table, with 52 cases in each group. Two groups were treated with conventional treatment, including anti-cough, anti-asthma, anti-infection and anti-febrile. The control group was treated with dexamethasone, while the observation group received alveolar lavage on the basis of the control group. Clinical effects, disappearance time of clinical symptoms (remission time of cough and dyspnea, fever duration, disappearance time of lung rales and X-ray shadow), length of stay, levels of inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) before and after treatment, levels of sICAM-1 and TIMP-1 and incidence of adverse drug reactions of two groups were compared. Results: The total effective rate of the observation group was 94.23%, significantly higher than 71.15% of the control group (P<0.01). Compared with the control group, the disappearance time of clinical symptoms and length of stay in the observation group were significantly shorter (P<0.05). After treatment, the levels of inflammatory factors (TNF-α, IL-6 and IL-8) in two groups were significantly lower than those before treatment, compared with the control group, the levels of inflammatory factors in the observation group were significantly lower (P<0.01). After treatment, the levels of sICAM-1 and TIMP-1 in two groups were significantly lower than those before treatment, compared with the control group, the observation group were significantly lower (P<0.01). No adverse drug reactions related to dexamethasone were observed in two groups, and 5 cases in the observation group developed complications of bronchofiberoscope alveolar lavage, which were relieved after treatment. Conclusion: Dexamethasone combined with bronchoalveolar lavage is effective in the treatment of lobar pneumonia, which can significantly reduce the levels of inflammatory factors and improve the levels of serum sICAM-1 and TIMP-1, promote the relief of children’s symptoms, rapidly control the condition and shorten the length of stay |
| Key words: lobar pneumonia dexamethasone, bronchoalveolar lavage tissue inhibitors of matrix metalloproteinase-1 soluble intercellular adhesion molecule-1 |
