复可托治疗小儿反复肺炎支原体感染的疗效及对免疫功能和肺功能的影响

摘要

目的:探讨复可托辅助治疗小儿反复肺炎支原体(MP)感染的疗效及对患儿免疫功能、肺功能的影响.方法:选取西安市儿童医院儿科2016年1月至2017年1月收治的反复MP感染患儿78例,随机分为观察组与对照组,每组39例.对照组应用常规治疗,观察组在常规治疗基础上加用复可托治疗.比较两组临床疗效,分别于治疗前、后检测免疫学指标和肺功能指标.结果:观察组治疗总有效率为97.44％,明显高于对照组的82.05％(P＜0.05).治疗后,观察组患者血清IgA、IgM、IgG、CD4+、CD4+/CD8+高于对照组,CD8+低于对照组(P＜0.05).观察组治疗后第1秒用力呼气容积(FEVl)、用力肺活量(FVC)、呼气峰流速(PEF)及25％、50％、75％用力呼气流速(FEF25、FEF50、FEF75)均高于对照组(P＜0.05).随访6个、12个月,观察组复发率分别为2.56％、5.71％,显著低于对照组的20.51％、30.30％(P＜0.05).结论:复可托辅助治疗小儿反复MP感染能够提高临床疗效,改善免疫功能和肺功能,降低MP感染复发率.%Objective:To investigate the effect of spleen aminopeptide oral lyophilized powder for children with recurrent mycoplasma pneumoniae (MP) infection,and to observe its influence on immune function and pulmonary function of children.Methods:A total of 78 children with recurrent MP infection admitted to our hospital from January 2016 to January 2017 were selected and randomly divided into an observation group and a control group,with 39 cases in each group.The children in the control group received routine therapy,and those in the observation group received routine therapy with addition of spleen aminopeptide.The clinical efficacy,the immune function and pulmonary function before and after treatment were observed and compared.Results:The total effective rate of the observation group was 97.44％,which was significantly higher than that of the control group (82.05％) (P＜0.05).After treatment,the IgA,IgM and IgG levels in serum as well as the percentage of CD4+ T cells and CD4+/CD8+ ratio in the observation group were higher than those in the control group,while the percentage of CD8+ T cells was lower (P＜ 0.05).The forced expiratory volume within one second (FEV1),forced vital capacity (FVC),peak expiratory flow (PEF),FEF after 25％ of vital capacity had been expelled (FEF25),FEF after 50％ of vital capacity had been expelled (FEF50) and FEF after 75％ of vital capacity had been expelled (FEF75) in the observation group were higher than those of the control group (P＜0.05).The recurrence rates at 6-month and 12-month follow-up were 2.56％ and 5.71％ respectively in the observation group,which were significantly lower than those in the control group (20.51％ and 30.30％) (P＜0.05).Conclusion:Spleen aminopeptide was effective in children with recurrent MP infection.It could improve the immune function and pulmonary function of children,and reduce the recurrence rate of MP infection.