Study on improving effect of methylprednisolone on serum Periostin,Gal-3,and SDF-1 in children with severe pneumonia and influencing factors of therapeutic effect
Objective To study the improvement effect of methylprednisolone on serum Periostin,galectin-3(Gal-3),and stromal cell derived factor-1(SDF-1)in children with severe pneumonia(SP)and the influencing factors of therapeutic effect.Methods A total of 103 children with SP who were admitted to Ankang Central Hospital from May 2020 to May 2023 were selected,and were randomly divided into a coordination group(51 cases)and a azithromycin group(52 cases)according to the order of admission.In the azithromycin group,there were 37 boys and 15 girls,the age was(6.84±1.56)years old,the course of disease was(5.15±1.27)d,and the species of pathogenic bacteria were(1.50±0.42).In the coordination group,there were 35 boys and 16 girls,the age was(6.78±1.55)years old,the course of disease was(5.11±1.24)d,and the species of pathogenic bacteria were(1.48±0.41).The azithromycin group was treated with intravenous drip with 10 mg/kg of azithromycin once a day,and the coordination group was treated with intravenous drip with 1-2 mg/kg of methylprednisolone once a day on the basis of azithromycin.Both groups received continuous administration for 7 days.The efficacy,symptom disappearance time,and serum Periostin,Gal-3,and SDF-1 levels were compared between the two groups.Univariate analysis(t test and x2 test)and multivariate logistic regression analysis were used to identify the influencing factors of treatment ineffectiveness in SP children.Results The total effective rate of the coordination group was higher than that of the azithromycin group[88.24％(45/51)vs.63.46％(33/52)](,x2=8.597,P=0.003).The disappearance time of cough,fever,and lung rales in the coordination group were shorter than those in the azithromycin group[(4.61±0.82)d vs.(7.08±1.24)d,(3.20±0.56)d vs.(5.19±0.87)d,(5.09±1.34)d vs.(7.12±1.80)d](t=11.900,13.774,and 6.482,all P＜0.001).After treatment,the levels of serum Periostin,Gal-3,and SDF-1 in both groups were lower than those before treatment,and those in the coordination group were lower than those in the azithromycin group[(71.34±10.40)ng/L vs.(92.51±18.56)ng/L,(12.35±2.71)ng/L vs.(20.84±3.49)ng/L,(132.58±21.77)ng/L vs.(170.49±30.61)ng/L](t=7.122,13.771,and 7.231,all P＜0.001).Multivariate logistic regression analysis confirmed that the lesion involving multiple lung lobes,pathogen species＞1,and no methylprednisolone treatment were all risk factors for treatment failure in SP children(all P＜0.05).Conclusions Methylprednisolone is effective in the treatment of SP children,and can down-regulate the levels of serum Periostin,Gal-3,and SDF-1.The influencing factors of its curative effect include lesion involving multiple lung lobes,pathogen species＞1,and no methylprednisolone treatment.
万方数据
维普
