Effects of different doses of gamma globulin on clinical curative effect,immunity and inflammation level in children with severe pneumonia
Objective To explore the effects of different doses of gamma globulin on clinical curative ef-fect,immunity and inflammation level in children with severe pneumonia.Methods A retrospective analysis was performed on the clinical data of 98 children with severe pneumonia who were treated with basic therapy and gamma globulin in the hospital between January 2021 and April 2024.According to different doses of gamma globulin,children were divided into a high-dose group (56 cases,1 g·kg-1·d-1) and a low-dose group (42 cases,400 mg·kg-1·d-1).All children were treated for 10 d.The clinical curative effect,improvement time of symptoms (defervescence time,cough relief time,disappearance time of rale,recovery time of heart rate),pediatric critical illness score (PICS),immunoglobulins (IgG,IgA,IgM),T cell subsets (CD4+,CD8+,CD4+/CD8+),inflammatory fac-tors[C-reactive protein (CRP),interleukin-6 (IL-6),procalcitonin (PCT)]and adverse drug reactions (nausea,diar-rhea,dizziness and headache) in the two groups were observed.Results The response rate of treatment in high-dose group was higher than that in low-dose group (96.4％ vs 83.3％,P<0.05).The defervescence time,cough re-lief time,disappearance time of rale,recovery time of heart rate and PICS in high-dose group[(4.4±1.3) d,(6.2±1.2) d,(6.3±1.4) d,(2.1±0.4) d and (83.5±1.1) points]were lower than those in low-dose group[(5.8±1.0) d,(8.6±1.6) d,(7.6±1.1) d,(2.5±0.4) d,(81.7±1.0) points;P<0.05].The levels of IgG,IgA and IgM in high-dose group[(8.37±1.12) g/L,(1.36±0.31) g/L and (1.72±0.37) g/L]were higher than those in low-dose group[(7.22±1.24) g/L,(1.07±0.29) g/L,(1.44±0.26) g/L;P<0.05].The levels of CD4+and CD4+/CD8+in high-dose group[(38.74±5.33)％and (1.54±0.36)]were higher than those in low-dose group[(36.24±5.02)％,(1.34±0.29)％];while CD8+was lower than that in low-dose group[(25.16±4.18)％ vs (27.13±3.99)％,P<0.05).The levels of CRP,IL-6 and PCT in high-dose group were[(10.6±3.2) mg/L,(34.6±5.4) pg/ml,and (1.3±0.3) μg/L]were lower than those in low-dose group[(14.6±4.2) mg/L,(42.6±4.6) pg/mL,and (2.0±0.6) μg/L].There was no significant difference in incidence of adverse reactions between the two groups (12.5％ vs 9.5％,P>0.05).Conclusion Curative effect of high-dose gamma globulin is better in children with severe pneumonia,which can effectively alleviate clinical symptoms,en-hance immunity and reduce inflammatory response,with safety.
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