Ma Xingna, Gao Wei, An Jinyu
Xingna Ma, Department of Pediatric, Changzhou Cancer Hospital Affiliated to Soochow University, Changzhou, 213000, Jiangsu, China.
Wei Gao, Department of Pediatric, Changzhou Cancer Hospital Affiliated to Soochow University, Changzhou, 213000, Jiangsu, China.
Pak J Med Sci. 2022 Mar-Apr;38(4Part-II):826-832. doi: 10.12669/pjms.38.4.5203.
To investigate the effects of Reduning combined with gamma globulin on symptom improvement and serum levels of interleukin-6 (IL-6), 25-hydroxyvitamin D[25-(OH)D] and lactate dehydrogenase (LDH) in children with severe mycoplasma pneumonia (MP).
A total of 123 children with severe MP admitted to the Changzhou Cancer Hospital affiliated to Soochow University from May 2018 to April 2020 were selected as subjects and randomly divided into three groups: control Group-A, control Group-B and the observation group, with 41 cases in each group. Control Group-A was given with Reduning, control Group-B was treated with gamma globulin, while the observation group was treated with Reduning injection combined with gamma globulin. The clinical efficacy, symptom improvement, incidence of adverse reactions, serum levels of IL-6, 25-(OH)D, LDH, Toll-like receptor 4/myeloid differentiation factor 88 (TLR4/MyD88) signaling pathway and T lymphocyte subsets before and after treatment were statistically compared between the three groups.
The total effective rate of treatment in the observation group was higher than that in control Group-A and control Group-B (0.05); The time for body temperature, lung rales, and cough to return to normal in the observation group was shorter than that in control Group-A and control Group-B (0.05). After treatment, the observation group had lower serum levels of IL-6, LDH, and higher levels of 25-(OH)D compared with control Group-A and control Group-B (0.05). Moreover, the observation group had lower serum expressions of TLR4 and MyD88 (0.05), higher serum levels of CD4, CD4/CD8, and lower CD8 compared with control Group-A and control Group-B (0.05). No significant difference can be seen in the comparison of the incidence of adverse reactions between the three groups (0.05).
Reduning combined with gamma globulin in the treatment of severe MP is worthy of clinical promotion and application. With such a treatment regimen, the immune function of children with severe MP can be significantly enhanced, the inflammatory response can be suppressed, and symptom improvement can be promoted, further improving the treatment outcome.
探讨热毒宁联合丙种球蛋白对重症支原体肺炎（MP）患儿症状改善及血清白细胞介素-6（IL-6）、25-羟基维生素D[25-(OH)D]和乳酸脱氢酶（LDH）水平的影响。
选取2018年5月至2020年4月在苏州大学附属常州肿瘤医院收治的123例重症MP患儿作为研究对象，随机分为三组：A对照组、B对照组和观察组，每组41例。A对照组给予热毒宁，B对照组给予丙种球蛋白，观察组给予热毒宁注射液联合丙种球蛋白治疗。对三组治疗前、后的临床疗效、症状改善情况、不良反应发生率、血清IL-6、25-(OH)D、LDH水平、Toll样受体4/髓样分化因子88（TLR4/MyD88）信号通路及T淋巴细胞亚群进行统计学比较。
观察组治疗总有效率高于A对照组和B对照组（P<0.05）；观察组体温、肺部啰音及咳嗽恢复正常时间短于A对照组和B对照组（P<0.05）。治疗后，观察组血清IL-6、LDH水平低于A对照组和B对照组，25-(OH)D水平高于A对照组和B对照组（P<0.05）。此外，观察组血清TLR4和MyD88表达低于A对照组和B对照组（P<0.05），血清CD4、CD4/CD8水平高于A对照组和B对照组，CD8水平低于A对照组和B对照组（P<0.05）。三组不良反应发生率比较差异无统计学意义（P>0.05）。
热毒宁联合丙种球蛋白治疗重症MP值得临床推广应用。采用该治疗方案可显著增强重症MP患儿的免疫功能，抑制炎症反应，促进症状改善，进而提高治疗效果。
