摘要
目的 观察小剂量地塞米松治疗新生儿胎粪吸人性肺炎的疗效及对炎性细胞因子的影响.方法 选择胎粪吸人性肺炎新生儿60例,随机方法分为观察组和对照组各30例,对照组常规综合治疗,观察组在对照组治疗基础上给予地塞米松治疗,连用3d,第1天0.5 mg/kg,第2天0.25 mg/kg,第3天0.1 mg/kg,7d后观察两组血气指标白细胞介素（IL-6、IL-8）、肿瘤坏死因子（TNF2a）变化情况,评价两组临床疗效,记录患儿需氧时间及住院时间.结果 观察组总有效率96.67％（29/30）,明显高于对照组的76.67％（23/30）（x2=6.497,P＜0.05）；治疗7d后观察组血气指标优于对照组,观察组平均吸氧总时间为（6.1±1.7）d,显著少于对照组的（10.2±2.4）d（t =5.673,P＜0.01）；治疗后观察组和对照组IL-6、IL-8、TNF2a分别为（1.21±0.16）μg/L比（3.07±0.24） μg/L,（1.13±0.14）μg/L比（2.42±0.33） μg/L,（2.61±0.24）比（4.07±0.41）,差异有统计学意义（均P＜0.01）.结论 小剂量地塞米松能够降低新生儿吸人性肺炎血清炎性细胞因子水平,减轻肺炎性反应,改善气体交换,缩短需氧时间与住院时间,有利于疗效提高.
Objective To observe the effect of low-dose dexamethasone in the treatment of neonatal meconi- um aspiration pneumonia and its influence on inflammatory cyt0kines. Methods 60 cases with neonatal meconium aspiration pneumonia were randomly divided into observation group and control group, 30 eases in each group. The control group was given conventional treatment, the observation group was given low-close dexamethasone treatment on the basis of the control group. Both groups had been treated for 3d,first ld 0.5mg/kg,2d O. 25mg/kg,3d 0. lmg/kg. After 7 days, blood gas indicators and serum IL-6, IL-8,TNF2awere detected, the. clinical efficacy was evaluated, the time of oxygen requirement and length of stay were recorded. Results The total effective rate of observation group and control group was 96.67% （29/30） and 76.67% （23/30） （ X2 = 6. 497, P 〈 0.05 ）. The indicators of the obser- vation group were significantly better than the control group, the average oxygen total time of the observation group and the control group was （6.1 ± 1.7 ） d and （ 10.2±2.4） d （ t = 5. 673, P 〈 0.01 ）. IL-6, IL-8, TNF2a of observation group and control group after treatment were （1.21 ± 0. 16 ）μg/L vs （3.07 ± 0.24 ）μg/L, （1.13 ± 0.14 ）μg/L vs （2.42 ±0.33）μg/L,（2.61 ±0.24） vs （4.07 ±0.41） （all P〈0.01）. Conclusion The low-dose dexamethasone can reduce inflammatory cytokines levels and lung iifflammation reaction,improve gas exchange, shorten the the aero- bic time and the length of hospital stay, improve the short-term effect.
出处
《中国基层医药》
CAS
2013年第15期2335-2337,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
胎粪吸入性肺炎
婴儿
新生
地塞米松
炎性细胞因子
Meconium aspiration pneumonia
Infant, newborn
Dexamethasone
Inflammatory Cytokines
