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[摘要]
目的 研究人免疫球蛋白联合注射用盐酸去甲万古霉素对新生儿败血症免疫功能和外周血清炎性因子的影响。方法 选择2013年1月—2017年12月在荆州市中心医院进行诊治的61例新生儿败血症患儿作为研究对象,随机分为对照组(31例)和观察组(30例)。对照组患儿静脉滴注注射用盐酸去甲万古霉素,对于日龄<7 d的新生儿静脉滴注的剂量为10 mg/kg,2次/d,对于日龄>7 d的新生儿静脉滴注的剂量为10 mg/kg,3次/d;观察组在对照组基础上联合静脉滴注人免疫球蛋白,每天400 mg/kg,两组均治疗5 d。观察两组患儿的临床疗效,比较两组住院时间、症状改善时间及治疗前后的外周血清炎性因子水平、免疫功能指标。结果 治疗后,观察组的有效率为86.67%,明显高于对照组的67.74%,两组有效率比较差异有统计学意义(P<0.05)。治疗后,观察组神经系统症状改善时间、住院时间、拒奶改善时间以及体温改善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,两组外周血清白介素(IL)-6、肿瘤坏死因子-α(TNF-α)、IL-23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);且观察组以上指标明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组CD4+/CD8+、CD3+和CD4+均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组免疫功能指标明显高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 人免疫球蛋白联合注射用盐酸去甲万古霉素可有效改善新生儿败血症的免疫功能,降低外周血清炎性因子水平,提高临床效率,值得临床推广应用。
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[Abstract]
Objective To investigate the effect of Human Immunoglobulin combined with Norvancomycin Hydrochloride for Injection on immune function and peripheral serum inflammatory factors in neonatal septicemia. Methods Patients (61 cases) with neonatal septicemia in Jingzhou Central Hospital from January 2013 to December 2017 were divided into control (31 cases) and observation (30 cases) group randomly. Children in the control group was intravenous drip of Norvancomycin Hydrochloride for Injection, the intravenous infusion dose was 10 mg/kg for newborns younger than 7 days of age, twice daily, and 10 mg/kg for newborns older than 7 days of age, three times daily. Children in the observation group were iv administered with Human Immunoglobulin on the basis of control group, 400 mg/kg daily. Children in two groups were treated for 5 d. After treatment, clinical efficacy was observed, and the hospitalization time, symptoms improvement time, and the levels of inflammatory factors and immune function indexes before and after treatment in two groups were compared. Results After treatment, the clinical efficacy in the observation was 86.67%, which was significantly higher than 67.74% in the control group, and there was difference between two groups (P<0.05). After treatment, the time of nervous system symptoms improvement, hospitalization, and the improvement time of refusing milk and temperature in the observation group were significantly shorter than those in the control group, and there was difference between two groups (P<0.05). After treatment, the levels of IL-6, TNF-α, and IL-23 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And these indexes in the observation group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, CD4+/CD8+, CD3+ and CD4+ in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the immune function indexes in the observation group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Human Immunoglobulin combined with Norvancomycin Hydrochloride for Injection can effectively improve the immune function of neonatal septicemia, reduce the level of peripheral serum inflammatory factors, and improve the effective rate of treatment. It is worthy of clinical application.
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