干扰素治疗126例新生儿呼吸道合胞病毒肺炎疗效观察

发布时间：2018-11-16 16:31

【摘要】：目的：观察干扰素在治疗新生儿呼吸道合胞病毒肺炎中的临床作用及安全性。方法：回顾性分析2011年2月-2012年3月于重庆医科大学附属儿童医院新生儿诊治中心住院，，诊断为新生儿呼吸道合胞病毒（RSV）肺炎的患儿286例，根据是否使用干扰素分为治疗组126例和对照组160例。在常规治疗基础上治疗组给予注射用重组人干扰素α1b1μg/kg.次，每天1次，肌肉注射，连用3天。收集患儿一般资料、临床症状、实验室检查结果，对治疗后主要临床症状好转时间、吸氧时间、住院时间及不良反应等进行比较。结果： 1.治疗组和对照组在日龄、胎龄、产重、入院前病程、喂养方式、性别组成等一般资料方面对比无显著性差异(p0.05)。 2.新生儿RSV肺炎患儿主要临床表现为咳嗽（93.0%）、气促（90.1%）、发绀（67.8%）、呛奶（62.9%）、肺部湿罗音（58.4%）。两组病例临床表现无显著性差异(P0.05)。 3.286例患儿中痰培养结果阳性者为66.8%（191/286）。其中常见细菌感染分别为大肠埃希氏菌21.5%(41/191)、肺炎克雷伯菌20.4%(39/191)、金黄色葡萄球菌17.2%（33/191）、鲍曼不动杆菌13.1%（25/191）、铜绿假单胞菌9.9%（19/191）。两组病例痰培养阳性率和常见细菌菌谱均无显著性差异(P0.05)。 4.治疗组主要临床症状(咳嗽、气促、呛奶、唇周发绀及肺部Up音)的好转时间及吸氧时间明显短于对照组，有显著性差异（P0.05），治疗组住院时间较对照组稍短，但无显著性差异（P0.05）。 5.治疗过程中治疗组有2例用药后2-6小时内出现发热，余病例未发现明显不良反应。结论：短期使用干扰素治疗新生儿呼吸道合胞病毒肺炎疗效较好，不良反应轻微，可以作为临床治疗新生儿RSV肺炎药物之一。
[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 伪 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.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R722.135

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