急性呼吸道疾病患儿肺炎综合治疗的优化

I.I. Pylyuk
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Optimization the protocol treatment of pneumonia in children with recurrent acute respiratory infections by supplementing pathogenetic therapy with this drug made possible to improve the efficiency of treatment, what confirmed by the rapid regression of clinical manifestations of pneumonia (intoxication — to 1.9±0.04 days, cough — to 2.1±0.08 days, respiratory failure — to 1.7±0.08 days, shortness of breath — to 1.3±0.04 days, disorders of microcirculation and hemodynamics — to 2.1±0.05 and 1.8, respectively ± 0.09 days). This approach calls the decrease of percentage of children with pneumonic infiltration according to the control X-ray examination of the lungs — to 30.0%, myocardial hypoxia according to the ECG results — 20.0%, which made possible to reduce the duration of the course of antibiotic therapy to 2.0±0.04 days, inpatient treatment — to 2.2±0.08 bed-days. The positive dynamics laboratories values, clinical signs and instrumental methods of examination of such children occurred due to an increasing levels of glutathione reductase and glutathione transferase in the blood serum to 4 and 3 times, respectively, and a decreasing the content of glutathione peroxidase and gamma$glutamyl transpeptidase to 2.6 and 1.6 times. Conclusions. Supplement the protocol therapy of pneumonia in children with recurrent acute respiratory infections with a drug has antioxidant, antihypoxic and organoprotective effects promoted a rapid regression of clinical manifestations due to the improvement of the functional activity of the oxidative system of glutathione, which made possible to reduce the duration of the course of antibiotic therapy and inpatient treatment. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. 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引用次数: 0

摘要

目的:通过方案治疗联合具有抗氧化、抗缺氧和器官保护作用的药物,提高复发性急性呼吸道感染患儿肺炎的病原学治疗效果。材料和方法。对3 ~ 8岁肺炎患儿反复急性呼吸道感染的临床、实验室和仪器检查结果进行了分析。儿童已经接受了肺炎的标准治疗方案,并与一种具有抗氧化、抗缺氧和器官保护作用的药物联合使用。结果。优化肺炎复发性急性呼吸道感染患儿的治疗方案,辅以病机治疗,可提高治疗效率,肺炎临床表现(中毒-至1.9±0.04天,咳嗽-至2.1±0.08天,呼吸衰竭-至1.7±0.08天,呼吸短促-至1.3±0.04天,微循环和血流动力学紊乱-)迅速消退分别为2.1±0.05和1.8±0.09天)。该方法将肺部x线对照检查显示的肺浸润患儿比例降低至30.0%,心电图结果显示的心肌缺氧患儿比例降低至20.0%,从而使抗生素疗程缩短至2.0±0.04天,住院治疗时间缩短至2.2±0.08床日。由于血清谷胱甘肽还原酶和谷胱甘肽转移酶水平分别升高至4倍和3倍,谷胱甘肽过氧化物酶和谷胱甘肽转肽酶含量分别降低至2.6倍和1.6倍,这些儿童的阳性动态实验室值、临床体征和仪器检查方法均出现阳性。结论。在复发性急性呼吸道感染患儿肺炎方案治疗的基础上,补充具有抗氧化、抗缺氧和器官保护作用的药物,通过提高谷胱甘肽氧化系统的功能活性,促进临床表现的快速消退,从而缩短抗生素治疗和住院治疗的疗程。这项研究是按照《赫尔辛基宣言》的原则进行的。本研究方案经所有参与机构的当地伦理委员会批准。获得患者的知情同意进行研究。作者未声明存在利益冲突。关键词:儿童反复急性呼吸道感染,肺炎,治疗。
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Optimization of pneumonia complex therapy in children with acute respiratory diseases
Purpose — to improve the pathogenetic treatment of pneumonia in children with recurrent acute respiratory infections by combining of protocol therapy with a drug has antioxidant, antihypoxic and organoprotective effects. Materials and methods. The analysis of the results of clinical, laboratory and instrumental methods of examination of children with pneumonia at the age of 3–8 years which have recurrent acute respiratory infections has performed. Children have had received standard protocol treatment of pneumonia and combination with a drug has antioxidant, antihypoxic and organoprotective effects. Results. Optimization the protocol treatment of pneumonia in children with recurrent acute respiratory infections by supplementing pathogenetic therapy with this drug made possible to improve the efficiency of treatment, what confirmed by the rapid regression of clinical manifestations of pneumonia (intoxication — to 1.9±0.04 days, cough — to 2.1±0.08 days, respiratory failure — to 1.7±0.08 days, shortness of breath — to 1.3±0.04 days, disorders of microcirculation and hemodynamics — to 2.1±0.05 and 1.8, respectively ± 0.09 days). This approach calls the decrease of percentage of children with pneumonic infiltration according to the control X-ray examination of the lungs — to 30.0%, myocardial hypoxia according to the ECG results — 20.0%, which made possible to reduce the duration of the course of antibiotic therapy to 2.0±0.04 days, inpatient treatment — to 2.2±0.08 bed-days. The positive dynamics laboratories values, clinical signs and instrumental methods of examination of such children occurred due to an increasing levels of glutathione reductase and glutathione transferase in the blood serum to 4 and 3 times, respectively, and a decreasing the content of glutathione peroxidase and gamma$glutamyl transpeptidase to 2.6 and 1.6 times. Conclusions. Supplement the protocol therapy of pneumonia in children with recurrent acute respiratory infections with a drug has antioxidant, antihypoxic and organoprotective effects promoted a rapid regression of clinical manifestations due to the improvement of the functional activity of the oxidative system of glutathione, which made possible to reduce the duration of the course of antibiotic therapy and inpatient treatment. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: children with recurrent acute respiratory infections, pneumonia, treatment.
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