人免疫球蛋白联合阿奇霉素治疗儿童MPP并发胸腔积液的疗效分析及对免疫炎症的影响

Efficacy analysis of human immunoglobulin combined with azithromycin in treating children with MPP complicated by pleural effusion and its impact on immune inflammation

摘要

目的 探讨阿奇霉素单用或联合人免疫球蛋白治疗儿童支原体肺炎(MPP)并发胸腔积液的临床研究,并观察免疫球蛋白、炎症反应变化。方法 纳入并分析沧州市人民医院于2022年1月1日至2023年7月1日收治的100例MPP合并胸腔积液患儿,按抽签法随机设为观察组和对照组,每组各有50例患儿.观察组实施人免疫球蛋白联合阿奇霉素抗感染治疗,对照组实施阿奇霉素抗感染治疗.观察两组疗效、临床表现消失时间、免疫球蛋白水平、炎症因子水平和不良反应。结果 观察组治疗总有效率(92.00%)显著高于对照组(76.00%)(χ²=4.762,P<0.05);观察组发热、咳嗽、肺部啰音、喘憋、胸腔积液消失时间均比对照组更短(t值分别为9.650、5.640、9.541、8.251、5.838,P<0.05);相比于治疗前,治疗后两组免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平增加,且观察组数据更高(t值分别为2.891、6.662、5.628,P<0.05);相比于治疗前,治疗后两组肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)水平减少,且观察组数据更低(t值分别为7.732、8.570、9.738,P<0.05);观察组不良反应发生率(16.00%)高于对照组(10.00%),但差异无统计学意义(χ²=0.796,P=0.372)。结论 人免疫球蛋白联合阿奇霉素能显著改善支原体肺炎并发胸腔积液患儿的临床症状,调节免疫系统的平衡,有效减少过度的炎症反应,提高疗效,同时安全性良好.

Abstract

Objective To investigate the clinical efficacy of azithromycin alone or in combination with human immunoglobulin in treating children with mycoplasma pneumoniae pneumonia (MPP) complicated by pleural effusion, and to observe changes in immunoglobulin levels and inflammatory responses. Methods A total of 100 children with MPP and pleural effusion admitted to Cangzhou People's Hospital from January 1, 2022, to July 1, 2023, were enrolled and randomly assigned into an observation group and a control group, with 50 patients in each group. The observation group received a combination therapy of human immunoglobulin and azithromycin, while the control group received azithromycin alone. The study assessed treatment efficacy, time to symptom resolution, immunoglobulin levels, inflammatory cytokine levels, and adverse reactions. Results The total effective rate of the observation group (92.00%) was higher than that of the control group (76.00%) (χ²=4.762, P<0.05). The resolution times for fever, cough, lung rales, dyspnea, and pleural effusion were significantly shorter in the observation group compared to the control group (t=9.650, 5.640, 9.541, 8.251 and 5.838, respectively, P<0.05). After treatment, levels of immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) increased in both groups, with significantly higher levels in the observation group (t=2.891, 6.662 and 5.628, respectively, P<0.05). Conversely, levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and interleukin-1β (IL-1β) decreased in both groups, with significantly lower levels in the observation group (t=7.732, 8.570 and 9.738, respectively, P<0.05). The incidence of adverse reactions in observation group (16.00%) was higher than that in control group (10.00%), but the difference was not statistically significant (χ²=0.796, P=0.372). Conclusion The combination of human immunoglobulin and azithromycin significantly improves clinical symptoms in children with MPP complicated by pleural effusion, helps regulate immune system balance, effectively reduces excessive inflammatory responses, and enhances treatment efficacy while maintaining good safety.

关键词

儿童 / 支原体肺炎 / 胸腔积液 / 人免疫球蛋白 / 肿瘤坏死因子-α / 白细胞介素-8 / 白细胞介素-1β

Key words

child / mycoplasma pneumoniae pneumonia / pleural effusion / immunoglobulin / tumor necrosis factor-α / interleukin-8 / interleukin-1β

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基金资助

沧州市科技计划项目(222106030)