静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效 及外周血 NLR、PCT 变化观察.

Objective: To observe the curative effect of intravenous injection of human immunoglobulin combined with vancomycin in the treatment of children with sepsis, and changes in peripheral blood neutrophil-to-lymphocyte ratio (NLR) and Procalcitonin (PCT). Methods: Eighty children with sepsis admitted to the hospital from January 2011 to January 2020 were selected as the research subjects. They were divided into control group and observation group according to the random number table method, with 40 cases in each group. Children in control group were treated with vancomycin, and those in observation group were treated with intravenous injection of human immunoglobulin based on the treatment of control group. Clinical efficacy, symptom improvement time, length of hospital stay, NLR, PCT, Procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), White blood cell count (WBC), immune function and the incidence of adverse reactions were compared between the two groups. Results: The treatment response rate in observation group was higher than that in control group (87.50% vs. 65.00%)(P<0.05). The improvement time of nervous system symptoms, body temperature and milk refusal, and the length of hospital stay in observation group [(6.22± 1.05) d, (3.88± 0.25) d, (5.10± 0.86) d and (8.71± 2.05) d] were shorter than those in control group [(8.76± 1.53) d, (6.22± 0.64) d, (7.53± 1.46) d and (11.24± 3.36) d] (P<0.05). After treatment, peripheral blood NLR, serum PCT, hs-CRP and WBC levels in observation group [(1.35± 0.20), (0.80± 0.34) mg/mL, (3.56± 0.62) g/L and (9.12± 1.80)× 109 /L] were significantly lower than those in control group [(1.83± 0.32), (2.19± 0.73) mg/mL, ( 9. 78 ± 2. 64 ) g/L and ( 12. 26 ± 2. 59 ) × 109 /L ] (P<0. 05 ). After treatment, CD4+, CD3+ and CD4/CD8 in observation group [(42.77± 11.36)%, (41.27± 11.26)% and (1.70± 0.33)] were significantly higher than those in control group [(35.80± 9.32)%, (35.66± 9.40)% and (1.29± 0.25)](P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (10.00% vs. 7.50%) (P>0.05). Conclusion: Intravenous injection of human immunoglobulin combined with vancomycin is effective in the treatment of children with sepsis, which Can reduce inflammatory factors, and improve immune function, with high safety. [ABSTRACT FROM AUTHOR]