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目的探讨丙种球蛋白辅助治疗新生儿肺炎患儿的临床疗效,及其对免疫功能的影响,为合理制定新生儿肺炎预防保健措施提供临床依据。方法取120例新生儿肺炎病例,随机分为3组,各组40例;对照组常规治疗,小剂量组与大剂量组在对照组基础上分别予低剂量和高剂量的丙种球蛋白。比较各组之间疗效,并记录观察患儿入院时、治疗3d、7d后的静脉血免疫学指标。结果小剂量组的整体有效率高于大剂量组和对照组,差异有统计学意义(P<0.05)。治疗前,各组患者考察指标的基线水平均无统计学差异(P>0.05)。治疗后,小剂量组与大剂量组的IgG、IgA及IgM水平均有所升高,高于对照组同期水平,且3d高于7d,大剂量组高于小剂量组;各指标差异有统计学意义(P<0.05)。小剂量组与大剂量组的IL-6与TNF-α水平均有所降低,低于对照组同期水平,且7d降低于3d,小剂量组低于大剂量组;各指标差异有统计学意义(P<0.05)。小剂量组与对照组的CD3、CD4、CD4/CD8均有所提高,小剂量组CD3、CD4水平均高于对照组,CD4/CD8水平仅3d时高于对照组;大剂量组仅3d的CD3水平有所升高,其他指标无明显变化或降低,且均低于对照组和小剂量组;各指标差异有统计学意义(P<0.05)。结论小剂量丙种球蛋白对新生儿肺炎的治疗方案是较为合理与理想的方法,值得临床推广。
Objective To investigate the clinical efficacy of gamma globulin in adjuvant treatment of children with neonatal pneumonia and its impact on immune function, so as to provide a clinical basis for rational development of neonatal pneumonia prevention and health care measures. Methods A total of 120 cases of neonatal pneumonia were randomly divided into 3 groups (40 in each group). In the control group, low-dose and high-dose gamma globulin were respectively given to the low-dose group and the high-dose group on the basis of the control group. The curative effect between the groups was compared, and the venous blood immunological indexes of the children after 3 and 7 days of treatment were recorded. Results The overall efficiency of the low-dose group was higher than that of the high-dose group and the control group, the difference was statistically significant (P <0.05). Before treatment, there was no significant difference (P> 0.05) in the baseline level of all the patients in each group. After treatment, the levels of IgG, IgA and IgM in low-dose group and high-dose group were all higher than those in the control group, and were higher than 7d in 3d and higher in high-dose group than in low-dose group Significance (P <0.05). The levels of IL-6 and TNF-α in low-dose group and high-dose group were lower than those in the same period of the control group, and decreased in 3d on the 7th day and lower than the high-dose group in the low-dose group. The differences were statistically significant (P <0.05). CD3, CD4, CD4 / CD8 of low dose group and control group were increased, CD3 and CD4 levels of low dose group were higher than that of control group, CD4 / CD8 level was higher than that of control group only at 3d; CD3 levels increased, other indicators no significant change or lower, and were lower than the control group and the small dose group; each index was statistically significant (P <0.05). Conclusion Low dose gamma globulin treatment of neonatal pneumonia is a more reasonable and ideal method, worthy of clinical promotion.