玉屏风颗粒治疗重症肺炎支原体肺炎患儿中淋巴细胞亚群功能变化的研究

摘要

Objective To investigate the effect of Yupingfeng granule on cellular immune function in chil-dren with severe mycoplasma pneumoniae(SMPP) and its clinical curative effect. Methods From June 2014 to Janu-ary 2017,62 children with pediatric SMPP were randomly divided into the observation group and the control group. In the observation group,31 patients were treated with azithromycin and Yupingfeng granule for 2 weeks after fever, and 31 patients in the control group were treated with azithromycin for 4 weeks. Lymphocyte subsets were measured before and after treatment. 30 healthy children were selected as the health group. Results The ratio of CD+3cells,CD+4cells and CD4/CD+8cells in children with severe mycoplasma pneumonia was significantly lower than that in the healthy group (P<0.01). The total acute NK cells in children with severe mycoplasma pneumonia were lower than those in the healthy group(P<0.05). The acute phase of CD+19cells in children with severe mycoplasma pneumonia was significantly higher than that in the healthy group (P<0.01). There was no significant difference in the acute phase of lymphocyte subsets between the observation group and the control group (P<0.05). The levels of CD+3, CD+4/CD+8in the subgroups were significantly higher than those in acute phase(P<0.05). The levels of CD+19in the recovery group were lower than those in the acute phase. The levels of CD+3, CD+4and CD+4/CD+8in the recovery group were significantly lower than those in the control group (P <0.05). There was no significant difference in CD19 + level between the control group and the recovery group(P>0.05). At the end of the second month,3 ca-ses lost follow-up in 62 cases of severe pneumonia mycoplasma pneumonia,29 cases in the observation group and 30 cases in the control group. There was 1 case of recurrence in the observation group and 3 cases in the control group (3.45% vs 10%). Conclusion There are significant lymphocyte subsets in children with severe mycoplasma pneu-monia. Yupingfeng granule adjuvant therapy can improve the immune function of children and prevent recurrence, which has important clinical value.%目的 探讨玉屏风颗粒治疗重症肺炎支原体肺炎(SMPP)患儿细胞免疫功能的影响及临床疗效.方法 选取2014年6月至2017年1月南方医科大学附属小榄医院儿科SMPP患儿62例,随机分为观察组和对照组.观察组31例给予阿奇霉素治疗,并在发热消退后加玉屏风颗粒治疗2周,对照组31例给予阿奇霉素治疗,共治疗4周.治疗前后分别检测淋巴细胞亚群.选择同龄健康体检儿童30例为健康组.结果(1) 重症肺炎支原体肺炎患儿急性期CD+3细胞、CD+4细胞、CD+4/CD+8细胞比值明显低于健康组,P<0.01;重症肺炎支原体肺炎患儿急性期总NK细胞低于健康组,P<0.05;急性期重症肺炎支原体肺炎患儿急性期CD+19细胞明显高于健康组P<0.01.(2) 观察组、对照组淋巴细胞亚群急性期无统计学差异,观察组、对照组的恢复期淋巴亚群CD+3、CD+4、CD+4/CD+8比值、总NK细胞高于急性期有统计学意义,P<0.05,两组恢复期CD+19水平低于急性期,有统计学意义(P<0.05)、;观察组恢复期CD+3、CD+4、CD+4/CD+8比值水平低于对照组,观察组恢复期CD+19水平与对照组恢复期CD+19水平无明显差异,无统计学意义(P>0.05).(3) 重症肺炎支原体肺炎患儿中62例,2个月末失访3例,纳入研究59例;观察患儿29例,对照组患儿30例.病情追踪2月再次出现呼吸道感染率观察组(1例)较对照组(3例)低(3.45%比10%).结论 重症肺炎支原体感染患儿存在明显淋巴细胞亚群功能紊乱.玉屏风颗粒辅助治疗可改善患儿细胞免疫功能,预防复发有重要的临床价值.