發(fā)布時間：2018-01-18 00:21

  本文關(guān)鍵詞：支原體肺炎急性期免疫功能變化及中藥槐杞黃干預(yù)的研究　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 肺炎支原體肺炎 免疫功能 槐杞黃顆粒 臨床療效

【摘要】：目的:研究MPP患兒不同影像學(xué)表現(xiàn)及其在不同年齡組中的分布;探討MPP患兒急性期免疫功能變化情況;觀察MPP患兒恢復(fù)期應(yīng)用槐杞黃顆粒在輔助治療該病中的臨床療效。方法:采用前瞻性、隨機抽樣的方法,選擇符合MPP納入標準的自2016年1月至2016年12月于大連市兒童醫(yī)院呼吸病房住院的患兒共100例,年齡為0-12歲。將符合納入標準的患兒根據(jù)胸部影像學(xué)表現(xiàn)的不同,分為大葉性MPP組和小葉性MPP組,分析MPP患兒的影像學(xué)改變,及其在各年齡組中的分布特點。入院后對符合納入標準的患兒進行免疫功能檢查,記錄結(jié)果并進行描述性分析,從而探討MP感染后患兒急性期免疫功能狀態(tài),及不同胸部影像學(xué)表現(xiàn)的MPP患兒的免疫變化特點;采用隨機數(shù)字表法,將所納入的MPP患兒分為槐杞黃組及對照組,兩組患兒住院期間均給予常規(guī)大環(huán)內(nèi)酯類藥物抗感染治療,僅槐杞黃組患兒出院后給予槐杞黃顆粒輔助治療3個月,并對所有MPP患兒愈后的第1個月及第3個月進行跟蹤隨訪并記錄當月患呼吸道感染的總?cè)藬?shù),通過比較兩組感染率,進而觀察槐杞黃對MPP患兒的臨床療效。結(jié)果:1.在符合納入標準的100例MPP患兒中,嬰幼兒24例,占24%;學(xué)齡前兒童43例,占43%;學(xué)齡期兒童33例,占33%;大葉性MPP37例,占37%;小葉性MPP63例,占63%;;其中在37例大葉性MPP患兒中,嬰幼兒期患兒為5例,占13.51%;學(xué)齡前期患兒為15例,占40.54%;學(xué)齡期患兒為17例,占45.94%;在63例小葉性MPP患兒中,嬰幼兒期患兒為20例,占31.75%;學(xué)齡前期患兒為27例,占42.86%;學(xué)齡期患兒為16例,占25.40%。2.在符合納入標準的并進行免疫功能檢查的48例患兒中,免疫功能異常的有35例,占72.92%;其中在免疫功能異常的患兒中,體液免疫功能異常的有23例,異常率占65.71%;細胞免疫功能異常的有5例,異常率占14.29%;體液免疫混合細胞免疫功能異常的有7例,異常率占20%3.在進行免疫功能檢查的48例患兒中,大葉性肺炎有18例,其中免疫功能異常的有13例,正常的有5例,異常率為72.22%;小葉性肺炎有30例,其中免疫功能異常的有28例,正常的有2例,異常率為76.67%。經(jīng)卡方檢驗,兩組患兒在MP感染后免疫功能異常率間的比較,P0.05,差異不顯著,無統(tǒng)計學(xué)意義。4.在符合納入標準并進行血清免疫球蛋白檢查的48例MPP患兒中,IgG水平升高的有1例,占2.08%,降低的有9例,占18.75%,異常率為20.83%;IgA降低的有19例,占39.58%,升高的有0例;IgM細胞升高的有12例,占25%,降低的有0例,占25%,異常率為25%。5.在符合納入標準并進行淋巴細胞亞群檢查的48例MPP患兒中,CD3細胞比例升高的有5例,占10.4%,降低的有0例;CD4細胞比例升高的有0例,降低的有3例,占6.3%;CD8細胞升高的有0例,降低的有4例,占8.3%;CD4/CD8細胞比值升高的有1例,占2%,降低的有0例;6.在符合納入標準的100例MPP患兒中,槐杞黃組共有58例,對照組42例。愈后第1個月,槐杞黃組有感染的人數(shù)有6人,無感染的有52人,感染率為10.3%;對照組有感染的人數(shù)有24人,無感染有18人,感染率為57.1%�；辫近S組患兒感染率明顯低于對照組,經(jīng)卡方檢驗,P0.01,差異顯著,具有統(tǒng)計學(xué)意義。愈后第3個月,槐杞黃組有感染的有3人,無感染的有55人,感染率為5.2%;對照組有感染的有15人,無感染的有27人,感染率為35.7%�；辫近S組患兒感染率明顯低于對照組,經(jīng)卡方檢驗,P0.01,差異顯著,具有統(tǒng)計學(xué)意義。結(jié)論:1.MPP的影像學(xué)改變與患兒的年齡間存在一定關(guān)系,嬰幼兒期及學(xué)齡前期患兒以小葉性MPP改變?yōu)橹?學(xué)齡期患兒以大葉性MPP改變?yōu)橹鳌?.肺炎支原體感染可引起機體特異性免疫功能紊亂,其中急性期主要以體液免疫紊亂為主,細胞免疫亦發(fā)生了一定變化。3.中藥槐杞黃顆粒在治療肺炎支原體肺炎的臨床療效上作用明顯,可顯著的降低肺炎支原體肺炎患兒在恢復(fù)期再次發(fā)生呼吸道感染的機率,對MPP的預(yù)后有著很好的改善作用。
[Abstract]:Objective: To study the MPP children with different imaging appearances and its distribution in different age groups; to investigate the change of immune function in children with acute MPP; observation of children with MPP recovery period using Huaiqihuang granules in the adjuvant treatment of the clinical effect of the disease. Methods: a prospective, random sampling method, in accordance with MPP standard from January 2016 to December 2016 in Dalian city children's hospital respiratory ward in hospital were 100 cases, aged 0-12 years old. In accordance with the standard of children according to the radiographic appearances of different, divided into lobar MPP group and MPP group of small leaves, changes with MPP image analysis, and the characteristics of the distribution in each in the age group after admission. The patients met the inclusion criteria for the assessment of immune function, and record the results of descriptive analysis, to explore the immune function of children with acute MP infection, and different chest The features of immune changes in MPP children in the Department of Radiology; using the method of random number table, will be included in MPP were divided into Huaiqihuang group and control group, two groups of children during hospitalization were given conventional macrolide antibiotic therapy, only Huaiqihuang group were discharged after Huaiqihuang granules adjuvant therapy for 3 months, and all the children with MPP after first months and 3 months were followed up and recorded the total number of patients with respiratory tract infection, compared with two groups of infection, and to observe the clinical efficacy of Huaiqihuang on patients with MPP. Results: 1. in 100 patients with MPP were included in the the standard, 24 infants, accounted for 24%; 43 preschool children, accounting for 43% of school-age children; in 33 cases, accounting for 33%; lobar MPP37 cases, accounting for 37%; lobular MPP63 cases, which accounted for 63%;; in 37 cases of lobar MPP children, infants were 5 cases, accounting for 13.51% preschool children was 15; For example, 40.54% of school-age children; in 17 cases, accounting for 45.94%; in 63 cases of lobular MPP children, infants were 20 cases, accounting for 31.75%; preschool children were 27 cases, accounting for 42.86%; 16 cases of school-age children, accounting for 25.40%.2. and immune function in the examination in accordance with the inclusion criteria in 48 cases, immune dysfunction in 35 cases, accounting for 72.92%; the abnormal immune function in children with humoral immune function were abnormal in 23 cases, the abnormal rate was 65.71%; cellular immune function abnormalities in 5 cases, the abnormal rate was 14.29%; humoral immune hybrid cellular immune function abnormalities in 7 cases and the abnormal rate was 20%3. in 48 cases of children with immune function tests, lobar pneumonia in 18 cases, the immune dysfunction in 13 cases, normal 5 cases, the abnormal rate was 72.22%; 30 cases of lobular pneumonia, including immune function abnormalities in 28 cases, normal 2 cases the abnormal rate was 76.. 67%.緇忓崱鏂規(guī)��楠，

本文編號：1438643