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目的:探讨支气管肺炎患儿药物治疗前后免疫功能的改变情况。方法:比较72例支气管肺炎患儿在采取阿奇霉素和匹多莫德治疗前及治疗一周后的细胞因子(SOD、TNF)、血清补体(C3、C4)、T细胞亚群(CD3+、CD4+、CD8+、CD19+、CD16+CD56+、CD3+CD4+Th、CD3+CD8+Ts、CD3+CD4+Th/CD3+CD8+Ts)、血清免疫球蛋白(IgG、IgA、IgM)水平。结果:支气管肺炎患儿在治疗一周后肺炎患儿的血清SOD水平显著高于治疗前,t=10.3426,P=0.000 0<0.01;血清TNF水平显著低于治疗前,t=4.893 9,P=0.000 0<0.01。治疗后一周肺炎患儿的CD3+(t=4.993 7,P=0.000 0<0.01)、CD4+(t=4.507 8,P=0.000 0<0.01)、CD16+CD56+(t=5.6198,P=0.0000<0.01)、CD3+CD4+Th(t=5.3126,P=0.000 0<0.01)、CD3+CD4+Th/CD3+CD8+Ts(t=5.451 3,P=0.000 0<0.01)高于治疗前,CD19+(t=5.127 5,P=0.000 0<0.01)、CD3+CD8+Ts(t=3.648 4,P=0.000 0<0.01)低于治疗前。治疗一周后,肺炎患儿的血清补体(C3、C4)水平显著高于治疗前(t=3.988 2,7.951 1;P=0.000 0<0.01);血清免疫球蛋白水平(IgG、IgA)显著高于治疗前(t=9.087 3,5.123 9;P=0.000 0<0.01),IgM与治疗前无显著差异,P>0.05。结论:支气管肺炎患儿存在免疫功能紊乱,通过常规的阿奇霉素联合匹多莫德治疗,可以短期有效改善患儿免疫功能,同时早期对支气管肺炎患儿进行免疫功能检测有助于指导治疗。
Objective: To investigate the changes of immune function in children with bronchial pneumonia before and after drug treatment. Methods: 72 cases of children with bronchial pneumonia were treated with azithromycin and pidotimod before and after one week treatment of cytokines (SOD, TNF), serum complement (C3, C4), T cell subsets (CD3 +, CD4 +, CD8 + , CD19 +, CD16 + CD56 +, CD3 + CD4 + Th, CD3 + CD8 + Ts, CD3 + CD4 + Th / CD3 + CD8 + Ts) and serum immunoglobulin (IgG, IgA, IgM). Results: The level of serum SOD in children with bronchopneumonia after one week of treatment was significantly higher than that before treatment (t = 10.3426, P = 0.000 0 <0.01). The level of serum TNF was significantly lower than that before treatment (t = 4.893 9, P = 0.000 0 <0.01. One week after treatment, CD3 + (+) in children with pneumonia was significantly higher than that in children with pneumonia (t = 4.993 7, P = 0.000 0 <0.01) CD3 + CD4 + Th (t = 5.3126, P = 0.000 0 <0.01), CD3 + CD4 + Th / CD3 + CD8 + (t = 5.127 5, P = 0.000 0 <0.01). CD3 + CD8 + Ts (t = 3.648 4, P = 0.000 0 <0.01) was lower than before treatment. After one week of treatment, serum levels of complement C3 and C4 in children with pneumonia were significantly higher than those before treatment (t = 3.988 2,7.951 1; P = 0.000 0 <0.01); serum immunoglobulin levels (IgG, IgA) Before treatment (t = 9.087 3,5.123 9; P = 0.000 0 <0.01), no significant difference was found between IgM and before treatment (P> 0.05). Conclusion: There are immunological disorders in children with bronchopneumonia. The treatment with azithromycin combined with pidotimod can effectively improve children ’s immune function in the short term. At the same time, early detection of immune function in children with bronchopneumonia is helpful to guide the treatment.