【摘要】：目的：觀察干擾素在治療新生兒呼吸道合胞病毒肺炎中的臨床作用及安全性。 方法：回顧性分析2011年2月-2012年3月于重慶醫(yī)科大學附屬兒童醫(yī)院新生兒診治中心住院，，診斷為新生兒呼吸道合胞病毒（RSV）肺炎的患兒286例，根據是否使用干擾素分為治療組126例和對照組160例。在常規(guī)治療基礎上治療組給予注射用重組人干擾素α1b1μg/kg.次，每天1次，肌肉注射，連用3天。收集患兒一般資料、臨床癥狀、實驗室檢查結果，對治療后主要臨床癥狀好轉時間、吸氧時間、住院時間及不良反應等進行比較。 結果： 1.治療組和對照組在日齡、胎齡、產重、入院前病程、喂養(yǎng)方式、性別組成等一般資料方面對比無顯著性差異(p0.05)。 2.新生兒RSV肺炎患兒主要臨床表現為咳嗽（93.0%）、氣促（90.1%）、發(fā)紺（67.8%）、嗆奶（62.9%）、肺部濕羅音（58.4%）。兩組病例臨床表現無顯著性差異(P0.05)。 3.286例患兒中痰培養(yǎng)結果陽性者為66.8%（191/286）。其中常見細菌感染分別為大腸埃希氏菌21.5%(41/191)、肺炎克雷伯菌20.4%(39/191)、金黃色葡萄球菌17.2%（33/191）、鮑曼不動桿菌13.1%（25/191）、銅綠假單胞菌9.9%（19/191）。兩組病例痰培養(yǎng)陽性率和常見細菌菌譜均無顯著性差異(P0.05)。 4.治療組主要臨床癥狀(咳嗽、氣促、嗆奶、唇周發(fā)紺及肺部Up音)的好轉時間及吸氧時間明顯短于對照組，有顯著性差異（P0.05），治療組住院時間較對照組稍短，但無顯著性差異（P0.05）。 5.治療過程中治療組有2例用藥后2-6小時內出現發(fā)熱，余病例未發(fā)現明顯不良反應。 結論：短期使用干擾素治療新生兒呼吸道合胞病毒肺炎療效較好，不良反應輕微，可以作為臨床治療新生兒RSV肺炎藥物之一。
[Abstract]:Objective: to observe the clinical effect and safety of interferon in the treatment of neonatal respiratory syncytial virus pneumonia. Methods: from February 2011 to March 2012, 286 cases of neonatal respiratory syncytial virus (RSV) pneumonia were analyzed retrospectively. According to whether to use interferon, 126 cases in treatment group and 160 cases in control group were divided into treatment group and control group. On the basis of routine therapy, the treatment group was given recombinant human interferon 偽 1b1 渭 g / kg for injection. Once a day, intramuscular injection for 3 days. The general data, clinical symptoms, laboratory results of children were collected, and the time of improvement of main clinical symptoms, time of oxygen inhalation, time of hospitalization and adverse reactions were compared after treatment. Results: 1. There was no significant difference between the treatment group and the control group in the general data of day age, gestational age, birth weight, course of disease before admission, feeding mode and sex composition (p0.05). 2. The main clinical manifestations of neonatal RSV pneumonia were cough (93.0%), shortness of breath (90.1%), cyanosis (67.8%), milk choking (62.9%) and wet rale of lung (58.4%). There was no significant difference in clinical manifestations between the two groups (P0.05). The positive rate of sputum culture in 3.286 cases was 66.8% (191 / 286). The common bacterial infections were Escherichia coli 21.5% (41 / 191), Klebsiella pneumoniae 20.4% (39 / 191), Staphylococcus aureus 17.2% (33 / 191), Acinetobacter baumannii 13.1% (25 / 191). Pseudomonas aeruginosa 9. 9% (19 / 191). There was no significant difference in sputum culture positive rate and bacteria spectrum between the two groups (P0.05). 4. The improvement time and oxygen inhalation time of the main clinical symptoms (cough, shortness of breath, choking milk, cyanosis around lips and pulmonary Up sound) in the treatment group were significantly shorter than those in the control group (P0.05). The hospitalization time of the treatment group was a little shorter than that of the control group. But there was no significant difference (P0.05). 5. In the treatment group, 2 cases had fever within 2 to 6 hours after medication, while no obvious adverse reactions were found in the remaining cases. Conclusion: the short-term use of interferon in the treatment of neonatal respiratory syncytial virus pneumonia is effective, and the adverse reaction is mild. It can be used as one of the drugs in the treatment of neonatal RSV pneumonia.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R722.135

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