目的 探讨静注人免疫球蛋白（pH 4）联合注射用更昔洛韦治疗小儿腺病毒肺炎的临床疗效。方法 选择2014年6月—2016年12月华中科技大学同济医学院附属武汉儿童医院收治的腺病毒肺炎患儿90例，所有患儿按随机数字表法随机分为对照组和治疗组，每组各45例。对照组静脉滴注注射用更昔洛韦，5 mg/kg，滴注时间> 1 h，2次/d。治疗组在对照组基础上静脉滴注静注人免疫球蛋白（pH 4），400 mg/kg，1次/d。两组患儿均连续治疗14 d。观察两组的临床疗效，比较两组的临床症状、肿瘤坏死因子-α（TNF-α）、分泌型磷脂酶A2（sPLA2）、克拉拉细胞分泌蛋白（CCSP）和白细胞介素-1（IL-1）水平情况。结果 治疗后，对照组和治疗组的总有效率分别为71.11%、95.56%，两组比较差异有统计学意义（P< 0.05）。治疗后，治疗组退热时间、咳嗽停止时间、咽痛消失时间、肺部湿啰音消失时间和住院时间均明显短于对照组，两组比较差异有统计学意义（P< 0.05）。治疗后，两组血清TNF-α、sPLA2、CCSP和IL-1水平均明显降低，同组治疗前后比较差异有统计学意义（P< 0.05）；且治疗组这些观察指标明显低于对照组，两组比较差异具有统计学意义（P< 0.05）。结论 静注人免疫球蛋白（pH 4）联合注射用更昔洛韦治疗小儿腺病毒肺炎具有较好的临床疗效，可改善临床症状，降低TNF-α、sPLA2、CCSP和IL-1水平，具有一定临床推广应用价值。

Objective To investigate the clinical effect of Human Immunoglobulin (pH 4) for intravenous injection combined with Ganciclovir for injection in treatment of adenoviral pneumonia in children. Methods Children (90 cases) with adenoviral pneumonia in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology from June 2014 to December 2016 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Ganciclovir for injection, 5 mg/kg, infusion time > 2 h, twice daily. Patients in the treatment group were iv administered with Human Immunoglobulin (pH 4) for intravenous injection on the basis of the control group, 400 mg/kg, once time. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptom, TNF-α, sPLA2, CCSP, and IL-1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.11% and 95.56%, respectively, and there was difference between two groups (P < 0.05). After treatment, pyretolysis time, cough stop time, sore throat disappear time, lung wet rales disappearance time, and hospitalization time in the treatment group were shorter than those in the control group, and there was difference between two groups (P < 0.05). After treatment, the levels of TNF-α, sPLA2, CCSP, and IL-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Human Immunoglobulin (pH 4) for intravenous injection combined with Ganciclovir for injection has clinical curative effect in treatment of adenoviral pneumonia in children, can improve clinical symptoms, and decrease the levels of TNF-α, sPLA2, CCSP, and IL-1, which has a certain clinical application value.