摘要
目的探讨双歧杆菌三联活菌联合地塞米松治疗重症肺炎的临床价值。方法选取淮安市第一人民医院2017年7月—2019年12月收治的104例重症肺炎患者,按照随机数字表法分为观察组与对照组,每组52例。两组均给予常规对症支持治疗,在此基础上,对照组给予地塞米松治疗,观察组给予双歧杆菌三联活菌+地塞米松治疗,均于2周后评价治疗效果。对比两组临床疗效、肺功能[第1秒用力呼气量(FEV1)、用力肺活量(FVC)及1秒率(FEV1/FVC)]、血清免疫指标[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]、血清炎症指标[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]及治疗安全性。结果观察组临床总有效率(94.23%)高于对照组(80.77%)(P<0.05);治疗后两组FEV1、FVC、FEV1/FVC参数均较治疗前升高,且观察组高于对照组(P<0.05);治疗后两组血清IgA、IgM、IgG水平均较治疗前升高,且观察组高于对照组(P<0.05);治疗后两组血清IL-6、IL-8、TNF-α水平均较治疗前下降,且观察组低于对照组(P<0.05);治疗期间,两组血常规、尿常规、心电图及肝、肾功能检查未见异常,观察组不良反应发生率(15.38%)与对照组(17.31%)比较差异无统计学意义(P>0.05)。结论双歧杆菌三联活菌联合地塞米松治疗重症肺炎效果显著,可有效改善患者肺功能,可能与调节血清免疫炎症介质有关,且安全性有保证。
Objective To explore the clinicalvalue ofBifidobacterium triple viable combined with dexamethasone in the treatmentofseverepneumonia.Methods Atotalof104 patientswithseverepneumoniaadmittedtotheAffiliatedHuaian No.1 HospitalofNanjingMedicalUniversityfromJuly2017 toDecember2019 wereselectedandrandomlydividedintoob-servation group and control group, with 52 cases in each group.On this basis, the control group was given dexamethasonetreatment, whilethe observation group was given Bifidobacterium triple viable + dexamethasone treatment, and the treat-ment effect was evaluated two weeks later.The clinical efficacy, lung function(FEV1, FVC, FEV1/FVC), serum immune in-dexes(IGA, IgM, IgG), serum inflammatory indexes(IL-6, IL-8, TNF-α) and treatment safetywere compared between thetwo groups.Results The total clinical effective rate of the observation group(94.23%) was higher than that of the controlgroup(80.77%)(P< 0.05).After the treatment, FEV1, FVC and FEV1/FVC parameters of the two groups were higher thanthose before the treatment, and the levelsin the observation group were higher than in the control group(P< 0.05).The levelsof serum IgA, IgM and IgG in the two groups after the treatment were higher than those before the treatment, and the levelsin the observation group were higher than those in the control group(P< 0.05).After the treatment, the levels of IL-6, IL-8 and TNF-α in the two groups were lower than those before the treatment, and the levels in the observation group were lowerthan those in the control group(P< 0.05).During the treatment, there were no abnormalities in blood routine, urine routine,ECG, liver and kidney function in the two groups. The incidence of adverse reactions in the observation group(15.38%) wasnot significantly different with the control group(17.31%)(P> 0.05).Conclusion Bifidobacterium triple viable combinedwith dexamethasone is effective in the treatment of severe pneumonia, which can effectively improve the lung function of pa-tients. It may be related to the regulation of serum immune inflammatory mediators, and the safety is guaranteed.
作者
曹炎炎
张荣
孙兵
陈亮
CAO Yanyan;ZHANG Rong;SUN Bing;CHEN Liang(Department of Respiratory and Critical Care Medicine,The Affiliated Huaian No.1 Hospital of Nanjing Medical University,Huai'an Jiangsu 223300,China)
出处
《新疆医科大学学报》
CAS
2020年第12期1571-1575,共5页
Journal of Xinjiang Medical University
基金
江苏省科技计划项目(ZC2018176)。
关键词
重症肺炎
地塞米松
盐酸氨溴索
双歧杆菌三联活菌
免疫炎症介质
severe pneumonia
dexamethasone
ambroxol hydrochloride
Bifidobacterium triple viable
immunoinflamma-tory mediators
