丙种球蛋白治疗重症类百日咳综合征疗效分析

摘要

目的探讨早期应用丙种球蛋白治疗1～3月龄重症类百日咳综合征患儿的临床疗效.方法选取2016年9月至2017年12月河南省儿童医院小婴儿科收治的重症类百日咳综合征患儿218例(采用鼻咽分泌物百日咳PCR排除百日咳者),随机分为对照组与观察组,各109例.对照组采用常规治疗,观察组采用常规治疗加用丙种球蛋白治疗,对两组临床疗效进行对比.结果观察组患儿痉挛性咳嗽时间(t=12.314,P=0.016)、肺部体征消失时间(t=12.335,P=0.041)、白细胞升高时间(t=11.289,P=0.024)、症状缓解时间(t=19.372,P=0.019)、住院时间(t=6.735,P=0.037)均显著少于对照组;对照组并发症发生率(22.02％)显著高于观察组(0)(Fisher's确切概率法,P=1.437×10-8),两组均未见不良反应.结论对重症类百日咳综合征患儿早期应用丙种球蛋白治疗,可有效改善其痉挛性咳嗽持续时间、肺部体征及临床症状,有助于快速缓解患儿病情,缩短住院时间,减少并发症的发生,有利于患儿早日恢复健康.%Objective To analyze the clinical effect of early application of immunoglobulin on infants aged 1-3months with severe pertussis-like syndrome.Methods Altogether 218infants with pertussis-like syndrome (using nasopharyngeal secretion pertussis PCR to exclude pertussis) treated in Infant Department of Children's Hospital of Henan Province from September 2016to December 2017were selected and randomly divided into control group and observation group with 109cases in each group.Patients in the control group received routine treatment, while patients in the observation group received additional immunoglobulin treatment on basis of routine treatment.Clinical effects were compared between two groups.Results Spastic cough duration time (t=12.314, P=0.016), pulmonary symptoms disappearing time (t=12.335, P=0.041), white blood cells increasing time (t=11.289, P=0.024), symptom remission time (t=19.372, P=0.019), and hospitalization time (t=6.735, P=0.037) in the observation group were significantly shorter than those in the control group.Incidence rate of complication in the control group (22.02％) was significantly higher than that in the observation group (0) (Fisher's exact probability method, P=1.437×10-8).No adverse reactions were found in both groups.Conclusion Immunoglobulin treatment at early stage for severe pertussis-like syndrome can effectively shorten duration of spasmodic cough, improve lung symptoms and clinical symptoms, help to ease illness quickly, shorten hospitalization time, and reduce occurrence of complications, and it is helpful for infants to recover quickly.