The effects of bronchoalveolar lavage combined with antibiotic downgrading therapy on cellular immunity,inflamma-tory response,and lung function in patients with severe pneumonia
Objective To study the clinical efficacy of bronchoalveolar lavage combined with antibiotic downgrad-ing therapy in the treatment of severe pneumonia(SP)patients and its impact on cellular immunity,inflammatory response,and lung function.Methods Sixty-six SP patients admitted to the Respiratory Department of the First People's Hospital of Nantong City,Jiangsu Province from July 2021 to December 2022 were selected as the research subjects.They were random-ly divided into an observation group of 33 cases and a control group of 33 cases using a random number table method.The control group received antibiotic ladder lowering therapy,while the observation group received bronchoalveolar lavage com-bined with antibiotic ladder lowering therapy.After 2 weeks of treatment,compare the clinical efficacy,adverse reactions,and changes in cellular immunity,inflammatory factors,and lung function indicators between the two groups before and af-ter treatment.Results The totaleffective rate of the observation group was 87.88%,significantly higher than the control group's 66.67%(χ2/P=4.228/0.040).After2 weeks of treatment,the cellular immune indicators CD3+,CD4+,and CD4+/CD8+ in the observation group were higher than those in the control group,while CD8+was lower than those in the control group(t/P=3.007/0.004,2.457/0.017,2.943/0.005,2.106/0.039).Serum inflammatory factor C-reactive protein(CRP),procalcito-nin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)were lower than the control group(t/P=3.027/0.004,3.636/0.001,4.829/<0.001,6.248/<0.001).The maximum expiratory flow(PEF),forced expiratory volume at 1 second(FEV1),and FEV1 to forced vital capacity(FVC)ratio(FEV1/FVC)were higher in the lung function group than in the control group(t/P= 7.631/<0.001,4.887/<0.001,5.406/<0.001).There was no statistically significant difference in adverse reactions between the two treatment groups(21.21%vs.12.12%,χ2/P=0.098/0.322).Conclusion Bronchoalveolar lavage combined with antibiot-ic downgrading therapy can improve the clinical efficacy of SP patients,which may be related to factors such as improving cellular immune function,antagonizing inflammatory reactions,and promoting lung function recovery.
Severe pneumoniaAntibiotic de-escalation therapyBronchoalveolar lavageCellular immune func-tionInflammatory factorsPulmonary function
维普
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