静脉滴注人免疫球蛋白辅助治疗重症肺炎的疗效观察.pdfVIP

静脉滴注人免疫球蛋白辅助治疗重症肺炎的疗效观察 1＊ 2 1 裴保香 ，吴润东 ，董圣惠 （1.解放军总医院药品保障中心，北京市 100853；2.大理医学院，大理市 671000） 中图分类号 R563 文献标识码 A 文章编号 1001-0408（2010）36-3409-03 摘 要 目的：观察静脉滴注人免疫球蛋白（IHIG ）辅助治疗重症肺炎的疗效。方法：调查入住我院呼吸科的重症肺炎患者共84 例，治疗组44例，对照组40例。2组均给予常规吸氧、排痰、抗感染等基础治疗。治疗组患者分为A 、B 亚组，分别在常规治疗的基 础上加用100～200mg ·kg－1·d－1和201～500mg ·kg－1·d－1的IHIG 。比较2组的临床症状、体征改善情况及临床疗效。采用临床肺 部感染评分（CPIS ）软件计分，评估患者的感染严重程度并比较用药前、后的分值变化情况与疗效的联系。结果：治疗组的咳嗽咳 痰缓解时间、痰菌转阴时间均较对照组缩短，有效率为63.6％，明显好于对照组（32.5％，P ＜0.05）。治疗A 组的X 线胸片炎症吸收 时间与对照组相比无显著性差异（P ＞0.05），但治疗B 组与对照组比较，差异有统计学意义（P ＜0.05）。治疗组在应用IHIG 后 CPIS 平均分值较应用前显著降低（P ＜0.05）。提示用药前、后的CPIS 分值变化与疗效联系紧密。结论：IHIG 辅助治疗重症肺炎 疗效显著，可以预防炎症失控，降低死亡率。 关键词 静脉滴注；人免疫球蛋白；重症肺炎；炎症失控；临床肺部感染评分 Efficacy Observation of Human Immune Globulin in the Treatment of Severe Pneumonia with Intravenous Infusion PEI Bao-xiang ，DONG Sheng-hui （Drug Security Center of PLA General Hospital ，Beijing 100853，China ） WU Run-dong （Dali Medical College ，Dali 671000，China ） ABSTRACT OBJECTIVE ：To observe efficacy of human immune globulin （IHIG ）via i.v. in the treatment of severe pneumonia. METHODS ：84patients with severe pneumonia in respiratory department were divided into treatment group （44 cases ）and control group （40 cases ）. Both groups were given conventional therapy ，such as inhaling oxygen ，clearing phlegm ，anti-infection therapy. Treatment group was divided into subgroup A and subgroup B. They were additionally given IHIG 100～200 mg ·kg －1 ·d －1 and IHIG 201～500mg ·kg －1·d－1. Clinical symptoms and signs and clinical efficacy were compared between 2 groups. Clinical pulmo- nary infection score （CPIS ）scoring software was used to evaluate the severity of infection. Relationship of score changes with effi- cacy was compared before and after treatment. RESULTS ：Relieve time of cough and expectoration and sputum bacterial conver- sion time in treatment group were shorter than