摘要:目的 探究人免疫球蛋白联合阿奇霉素序贯疗法对新生儿感染性肺炎(NIP)患儿T淋巴细胞亚群及血清降钙素原(PCT)、干扰素-γ(IFN-γ)水平的影响.方法 选取2013年6月至2016年1 1月本院86例NIP患儿,依据治疗方案不同分组,每组43例.对照组予以阿奇霉素序贯疗法治疗,观察组予以人免疫球蛋白+阿奇霉素序贯疗法治疗.疗程结束后,统计两组治疗效果,症状、体征消失时间及不良反应情况,并对比两组治疗前及疗程结束后T淋巴细胞亚群(CD4+/CD8+、CD4+、CD3+、CD8+)及血清PCT、IFN-γ水平.结果 两组治疗总有效率相比,观察组95.35%(41/43)明显高于对照组79.07%(34/43),差异有统计学意义(P<0.05).相较于对照组,观察组发热、肺部湿啰音及呼吸困难消失时间均较短,差异有统计学意义(P<0.05).两组治疗前T淋巴细胞亚群相关指标水平差异均无统计学意义(P> 0.05);两组治疗后CD8+水平差异均无统计学意义(P>0.05);相较于对照组,观察组治疗后CD4+/CD8+、CD4+、CD3+水平较高,差异有统计学意义(P<0.05).两组治疗前血清PCT、IFN-γ水平差异均无统计学意义(P> 0.05);相较于对照组,观察组治疗后血清PCT水平较低,IFN-γ水平较高,差异有统计学意义(P<0.05).观察组不良反应发生率16.29%(7/43)与对照组11.63%(5/43)相比,差异无统计学意义(P>0.05).结论 对NIP患儿予以人免疫球蛋白联合阿奇霉素序贯疗法治疗,可显著改善T淋巴细胞亚群,降低血清PCT水平,提高血清IFN-γ水平,有效促进患儿症状、体征恢复,且安全性较高,效果较为显著.%Objective To investigate the effect of human immunoglobulin combined with azithromycin sequential therapy on T lymphocyte subsets and serum procalcitonin (PCT) and interferon-γ(IFN-γ) levels in children with neonatal infectious pneumonia (NIP).Methods From June 2013 to November 2016,86 children with NIP in our hospital were selected,and were divided into control group and observation group according to different treatment regimens,43 cases in each group.The control group was treated with azithromycin sequential therapy,and the observation group was treated with human immunoglobulin + azithromycin sequential therapy.After the end of treatment,treatment effect,disappearance time of symptoms and signs,and adverse reactions of the two groups were statistically analyzed,and T lymphocyte subsets (CD4+/CD8+,CD4+,CD3+,CD8+),serum PCT and IFN-γ levels were compared before and after the end of treatment.Results The total effective rate of treatment of the observation group [95.35% (41/43)] was significantly higher than that of the control group [79.07% (34/43)],with statistically significant difference (P<0.05).Compared with the control group,the disappear time of fever,lung moist rales,and dyspnea in the observation group were shorter,with statistically significant differences (P<0.05).There were no statistically significant differences in T lymphocyte subsets related indicators levels between the two groups before treatment (P>0.05);there was no statistically significant difference in CD8+ level between the two groups after treatment (P>0.05);compared with the control group,the CD4+/CD8+,CD4+,CD3+ levels in the observation group were higher after treatment (P<0.05).There were no statistically significant differences in serum PCT and IFN-γ levels between the two groups before treatment (P>0.05);compared with the control group,the serum PCT level was significantly lower and the IFN-γ level was significantly higher in the observation group (P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group [16.29% (7/43)] and the control group [11.63% (5/43)] (P>0.05).Conclusion Human immunoglobulin combined with azithromycin sequential therapy in children with NIP can significantly improve the T lymphocyte subsets,reduce the serum PCT level,increase the serum IFN-γ level,effectively promote the recovery of symptoms and signs of children,with higher safety and more significant effect.