Abstract:

Objective　To investigate the effect of bacterial lysates combined with methylprednisolone on the lung function, immunoglobulin (Ig), and inflammatory factors in children with bronchopneumonia. Methods　A total of 98 children with bronchopneumonia admitted to Xuchang People's Hospital from April 2021 to April 2023 were selected as the research objects, and were randomly divided into a control group (49 cases) and an observation group (49 cases) according to the two-color sphere method. The control group included 25 boys and 24 girls, aged (7.59±1.52) years. The observation group included 27 boys and 22 girls, aged (8.01±1.72) years. The control group was given methylprednisolone treatment, intravenous infusion, 1 mg/kg, qd, continuous infusion for 3 days, and on the basis the observation group was given bacterial lysate capsules, 3.5 mg/time, qd, oral fasting daily for 10 days. The clinical efficacy, recovery time of clinical symptoms, forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), maximum expiratory flow (PEF), IgA, IgM, IgG, C-reactive protein (CRP), transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α), and interleukin-4 (IL-4) levels before and after treatment, incidence of adverse reactions were compared between the two groups. t test and χ² test were used. Results　After treatment, the total effective rate of the observation group was 97.96% (48/49), which was higher than that of the control group [83.67% (41/49)], with a statistically significant difference (P<0.05). The recovery time of high fever, cough, shortness of breath, and rales in the observation group were shorter than those in the control group, with statistically significant differences (all P<0.05). After treatment, the PEF, FVC, and FEV₁ levels in the observation group were (3.01±0.48) L/s, (1.56±0.22) L, and (1.39±0.28) L, which were higher than those in the control group [(2.72±0.39) L/s, (1.38±0.19) L, and (1.23±0.18) L], with statistically significant differences (all P<0.05). After treatment, the levels of IgA, IgM, and IgG in the observation group were (1.35±0.12) g/L, (1.44±0.31) g/L and (10.37±1.68) g/L, which were higher than those in the control group [(1.08±0.09) g/L, (1.11±0.36) g/L, and (8.35±0.79) g/L], with statistically significant differences (all P<0.05). After treatment, the levels of TGF-β1, CRP, IL-4, and TNF-α in the observation group were decreased more than those in the control group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions　Bacterial lysates combined with methylprednisolone is effective in the treatment of children with bronchopneumonia, which can improve the lung function, inhibit the expressions of inflammatory factors, and improve the immunity, with good safety.

Key words:

Bronchopneumonia, Children, Bacterial lysates, Methylprednisolone, Pulmonary function, Immunoglobulin

摘要：

目的　探究细菌溶解产物联合甲强龙对支气管肺炎患儿肺功能、免疫球蛋白（Ig）、炎症因子水平的影响。方法　选取2021年4月至2023年4月许昌市人民医院收治的98例支气管肺炎患儿为研究对象，依据双色球法将其随机分为对照组（49例）、观察组（49例）。对照组男25例，女24例，年龄（7.59±1.52）岁；观察组男27例，女22例，年龄（8.01±1.72）岁。对照组给予甲强龙治疗，静脉滴注，1 mg/kg，qd，连续滴注3 d，观察组在此基础上给予细菌溶解产物胶囊治疗，3.5 mg/次，qd，每日空腹口服，连续服用10 d。比较两组临床疗效，临床症状恢复时间，治疗前后用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、最大呼气流量（PEF）、IgA、IgM、IgG、C反应蛋白（CRP）、转化生长因子-β1（TGF-β1）、肿瘤坏死因子-α（TNF-α）、白细胞介素-4（IL-4）水平及不良反应发生率。采用t检验、χ²检验。结果　治疗后观察组总有效率97.96%（48/49），高于对照组83.67%（41/49），差异有统计学意义（P<0.05）。观察组高热、咳嗽、气促及啰音恢复时间均短于对照组，差异均有统计学意义（均P<0.05）。治疗后，观察组PEF、FVC、FEV₁水平分别为（3.01±0.48）L/s、（1.56±0.22）L、（1.39±0.28）L，高于对照组的（2.72±0.39）L/s、（1.38±0.19）L、（1.23±0.18）L，差异均有统计学意义（均P<0.05）。治疗后，观察组IgA、IgM、IgG水平分别为（1.35±0.12）g/L、（1.44±0.31）g/L、（10.37±1.68）g/L，高于对照组的（1.08±0.09）g/L、（1.11±0.36）g/L、（8.35±0.79）g/L，差异均有统计学意义（均P<0.05）。治疗后，观察组TGF-β1、CRP、IL-4及TNF-α水平降低幅度大于对照组，差异均有统计学意义（均P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论　细菌溶解产物联合甲强龙治疗支气管肺炎患儿疗效显著，可改善肺功能，抑制炎症因子表达，提高免疫力，安全性良好。

关键词:

支气管肺炎, 儿童, 细菌溶解产物, 甲强龙, 肺功能, 免疫球蛋白