本文關(guān)鍵詞：兒童支原體肺炎血及肺泡灌洗液中炎性指標(biāo)水平及意義　出處：《河北聯(lián)合大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 肺炎 肺炎支原體 兒童 支氣管肺泡灌洗液 炎癥指標(biāo) 白介素-6 白介素-10

【摘要】：目的1探討兒童難治性肺炎支原體肺炎血白細(xì)胞、血沉、C-反應(yīng)蛋白及支氣管肺泡灌洗液中細(xì)胞因子白介素-6、白介素-10水平變化及其臨床意義。2評價(jià)支氣管鏡檢及支氣管肺泡灌洗在兒童難治性肺炎支原體肺炎的應(yīng)用價(jià)值。 方法1選取唐山市婦幼保健院小兒呼吸科確診為難治性肺炎支原體肺炎且接受支氣管鏡檢及支氣管肺泡灌洗的97例患兒為研究對象，，作為實(shí)驗(yàn)組；選取同期在該院耳鼻喉科住院的30例支氣管異物患兒作為對照1組；選取同期在小兒呼吸科確診為難治性肺炎支原體肺炎未接受支氣管鏡檢查及支氣管肺泡灌洗的30例患兒作為對照2組，選取同期確診為普通肺炎支原體肺炎的100例患兒作為對照3組。2實(shí)驗(yàn)組及對照1組患兒進(jìn)行支氣管鏡檢查及支氣管肺泡灌洗后，采用雙抗體夾心ABC-酶聯(lián)免疫吸附法檢測其肺泡灌洗液中白介素-6、白介素-10水平；實(shí)驗(yàn)組和對照3組患兒均于入院當(dāng)天（或次日清晨空腹）抽血，分別檢測其血白細(xì)胞、血沉、C-反應(yīng)蛋白水平；實(shí)驗(yàn)組及對照2組患兒同時(shí)抽血檢測肺炎支原體抗體，其中肺炎支原體抗體檢測采用明膠顆粒凝集試驗(yàn)；實(shí)驗(yàn)組患兒以支氣管鏡檢術(shù)后治療1周體溫、咳嗽情況及肺部影像學(xué)改變，分顯效、有效、無效作為術(shù)后療效判斷標(biāo)準(zhǔn)，與對照2組在常規(guī)治療同療程下進(jìn)行療效比較。 結(jié)果1實(shí)驗(yàn)組BALF中白介素-6、白介素-10水平高于對照1組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。2實(shí)驗(yàn)組血中白細(xì)胞、血沉及C-反應(yīng)蛋白水平均明顯高于對照3組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。3實(shí)驗(yàn)組患兒常規(guī)治療的同時(shí)經(jīng)支氣管鏡檢及支氣管肺泡灌洗術(shù)后，平均熱退時(shí)間為入院后第4.48天，平均咳嗽減輕時(shí)間為入院后第5.54天，且1周后復(fù)查肺CT肺部病灶大部分或基本吸收65例，療效判斷總有效率為98.1%；對照2組單用常規(guī)治療同療程，平均熱退時(shí)間為入院后第9.33天，咳嗽減輕時(shí)間為入院后第10.40天，且1周后復(fù)查肺CT肺部病灶大部分或基本吸收13例，療效判斷總有效率為76.7%，實(shí)驗(yàn)組與對照2組患兒的療效比較（P0.05），差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論1白介素-6和白介素-10在難治性肺炎支原體肺炎患兒支氣管肺泡灌洗液中明顯增高，提示其在感染后引起的細(xì)胞免疫功能紊亂中發(fā)揮著一定的作用，對于免疫調(diào)節(jié)治療具有一定的指導(dǎo)意義。2兒童難治性肺炎支原體肺炎血白細(xì)胞、血沉、C-反應(yīng)蛋白水平均有不同程度的升高，這些炎性指標(biāo)的升高在一定程度上反映疾病的嚴(yán)重程度。3支氣管鏡檢查及支氣管肺泡灌洗可顯著提高難治性肺炎支原體肺炎的治愈率，是治療難治性肺炎支原體肺炎的重要手段。
[Abstract]:Objective 1 to investigate the relationship between leukocyte, erythrocyte sedimentation rate (ESR) and interleukin-6 (IL-6) in bronchoalveolar lavage fluid (BALF) in children with refractory mycoplasma pneumoniae pneumonia. Changes of Interleukin-10 level and its Clinical significance .2 to evaluate the value of bronchoscopy and bronchoalveolar lavage in children with refractory mycoplasma pneumoniae pneumonia. Methods 1 97 children with refractory mycoplasma pneumoniae pneumonia and bronchoalveolar lavage were selected as experimental group. 30 cases of bronchial foreign bodies hospitalized in the otolaryngology department of this hospital were selected as control group 1. Thirty children with refractory mycoplasma pneumoniae pneumonia diagnosed in respiratory department in the same period were selected as the control group, who were not examined by bronchoscopy and bronchoalveolar lavage. A total of 100 children with mycoplasma pneumoniae pneumonia were selected as control group (group .2) and control group (group 1) for bronchoscopy and bronchoalveolar lavage. The levels of interleukin-6 and interleukin-10 in alveolar lavage fluid were detected by double antibody sandwich ABC- enzyme linked immunosorbent assay. The patients in the experimental group and the control group were taken blood samples on the day of admission (or the next morning), and the levels of white blood cells and erythrocyte sedimentation rate (ESR) C-reactive protein were measured. Mycoplasma pneumoniae antibody was detected in both experimental group and control group, and gelatin particle agglutination test was used to detect mycoplasma pneumoniae antibody. The children in the experimental group were treated with bronchoscopy for 1 week after the treatment of body temperature, cough and pulmonary imaging changes, marked effect, effective, ineffective as the standard of postoperative curative effect. The therapeutic effect was compared with that of the control group under the same course of treatment. Results 1the levels of interleukin-6 and interleukin-10 in BALF in the experimental group were higher than those in the control group, and the difference was statistically significant (P 0.05). 2. The white blood cells in the experimental group were significantly higher than those in the control group. The levels of ESR and C-reactive protein were significantly higher than those of the control group (P 0.05.3). The children in the experimental group underwent bronchoscopy and bronchoalveolar lavage at the same time. The mean time of heat withdrawal was 4.48 days after admission, the average time of cough relief was 5.54 days after admission, and 65 cases of lung CT lung lesions were reexamined after one week. The total effective rate was 98.1. The average time of heat withdrawal was 9.33 days after admission and the time of cough relief was 10.40 days after admission. After 1 week, 13 cases of lung CT pulmonary lesions were reexamined, the total effective rate was 76.70.The curative effect of the experimental group and the control group was compared with that of the control group (P 0.05). The difference is statistically significant. Conclusion 1Interleukin-6 and interleukin-10 were significantly increased in bronchoalveolar lavage fluid of children with refractory mycoplasma pneumoniae pneumonia. It is suggested that it plays a certain role in the cellular immune dysfunction caused by infection, and has certain guiding significance for immunomodulation therapy. 2. Children with refractory mycoplasma pneumoniae pneumonia, blood white blood cells, erythrocyte sedimentation rate (ESR). The level of C-reactive protein increased in varying degrees. The elevation of these inflammatory markers to a certain extent reflects the severity of the disease. 3 bronchoscopy and bronchoalveolar lavage can significantly improve the cure rate of refractory mycoplasma pneumoniae pneumonia. It is an important method to treat refractory mycoplasma pneumoniae pneumonia.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R725.6

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