Value of antibiotic administration based on dynamic monitoring of SAA in treatment of severe pneumonia by electronic bronchoscopy combined with pulmicort

doi:10.3877/cma.j.issn.1674-0785.2023.03.013

Abstract

Abstract:

Objective

To investigate the value of antibiotic administration based on dynamic monitoring of serum amyloid A (SAA) in the treatment of severe pneumonia by electronic bronchoscopy combined with pulmicort.

Methods

A total of 60 children with severe pneumonia who were treated at our hospital from January 2020 to January 2021 were selected and divided into three groups according to the treatment method used, and were given pulmicort aerosol inhalation plus antibiotic treatment (control group), pulmicort aerosol inhalation plus electronic bronchoscopy plus conventional antibiotic treatment (observation group 1), and pulmicort aerosol inhalation plus electronic bronchoscopy plus antibiotic treatment based on SAA monitoring (observation group 1). The clinical efficacy of the three groups was compared, blood gas indexes and the incidence of adverse reactions were observed and counted, IL-6 and PCT were determined by enzyme-linked immunosorbent assay, SAA level was determined by colloidal gold immunochromatographic assay, and CRP level was detected by immunoturbidimetry.

Results

After treatment, the levels of PaO₂/FiO₂, SaO₂, PaO₂, FVC, PEF, and FEV₁ were significantly increased, and the levels of PaO₂/FiO₂, SaO₂, PaO₂, FVC, PEF, and FEV1 in the observation group 2 were significantly higher than those in the control group and the observation group 1 (P＜0.05). After treatment, SAA level in the observation group 1 and observation group 2 decreased over time, and SAA level in the observation group 2 was significantly lower than that in the control group and observation group 1 (P＜0.05). The levels of CRP, IL-6, and PCT in children after treatment decreased, and the levels of CRP, IL-6, and PCT in the observation group 2 were significantly lower than those in the control group and observation group 1 (P＜0.05). The time to disappearance of lung wet rales and cough, and the duration of hospital stay were shortened after treatment, and these indexes in group 2 were signficantly shorter than those in the control group and observation group 1 (P＜0.05). The total effective rate in the observation group 2 (95.00%) was significantly higher than those of the control group (60.00%) and observation group 1 (85.00%) (P＜0.05). The total incidence of adverse reactions in the observation group 1 (30.00%) was higher than that in the control group (10.00%) and observation group 2 (20.00%), but there was no statistical difference (P＞0.05).

Conclusion

Antibiotic administration based on dynamic monitoring of SAA has anti-inflammatory effects, improves blood gas condition, and shortens the treatment duration and hospitalization time in the treatment of severe pneumonia by electronic bronchoscopy combined with pulmicort. Dynamic monitoring of SAA level can assess the severity and prognosis of infection, which can help relieve the clinical symptoms and improve the lung function significantly.

Key words: Dynamic monitoring of SAA, Electronic bronchoscopy, Pulmicolingshu, Severe pneumonia, Calcitonin

Xuerong Qiu, Xiuqin Zhang, Huan Zhang, Ting Liu, Cuiqin Gao. Value of antibiotic administration based on dynamic monitoring of SAA in treatment of severe pneumonia by electronic bronchoscopy combined with pulmicort[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(03): 308-313.

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Figures/Tables 6

References 20

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组别	例数	PaO₂/FiO₂（mmHg）		SaO₂（%）		PaO₂（mmHg）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	20	127.66±0.34	287.40±11.31	89.24±1.62	91.64±1.17	49.96±6.02	88.26±3.52
观察1组	20	126.25±0.51^a	302.31±9.12^a	88.43±1.35^a	94.14±1.23^a	48.26±5.12^a	91.17±314^a
观察2组	20	127.72±0.36^b	328.76±17.24^b	89.13±1.28^b	98.76±1.56^b	49.94±6.52^b	98.38±3.72^b
F值		0.542	8.971	0.238	16.330	0.010	8.837
P值		00.591	＜0.001	0.813	＜0.001	0.992	＜0.001

组别	例数	PaO₂/FiO₂（mmHg）		SaO₂（%）		PaO₂（mmHg）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	20	127.66±0.34	287.40±11.31	89.24±1.62	91.64±1.17	49.96±6.02	88.26±3.52
观察1组	20	126.25±0.51^a	302.31±9.12^a	88.43±1.35^a	94.14±1.23^a	48.26±5.12^a	91.17±314^a
观察2组	20	127.72±0.36^b	328.76±17.24^b	89.13±1.28^b	98.76±1.56^b	49.94±6.52^b	98.38±3.72^b
F值		0.542	8.971	0.238	16.330	0.010	8.837
P值		00.591	＜0.001	0.813	＜0.001	0.992	＜0.001

组别	例数	治疗前	治疗后3 d	治疗后5 d	治疗后7 d
对照组	20	311.91±68.78	41.83±14.62	26.07±8.57	15.51±5.41
观察1组	20	310.95±68.72^a	35.46±13.54^a	18.72±7.42^a	12.04±4.32^a
观察2组	20	311.20±67.39^b	22.73±10.51^b	11.14±4.32^b	7.16±2.14^b
F值		0.033	4.744	6.957	6.419
P值		0.974	＜0.001	＜0.001	＜0.001

组别	例数	治疗前	治疗后3 d	治疗后5 d	治疗后7 d
对照组	20	311.91±68.78	41.83±14.62	26.07±8.57	15.51±5.41
观察1组	20	310.95±68.72^a	35.46±13.54^a	18.72±7.42^a	12.04±4.32^a
观察2组	20	311.20±67.39^b	22.73±10.51^b	11.14±4.32^b	7.16±2.14^b
F值		0.033	4.744	6.957	6.419
P值		0.974	＜0.001	＜0.001	＜0.001

组别	例数	CRP（mg/L）		IL-6（pg/ml）		PCT（ng/ml）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	20	84.76±7.18	31.40±6.21	46.53±1.72	25.64±1.17	3.91±0.78	1.51±0.41
观察1组	20	83.25±8.03^a	19.31±6.63^a	46.43±1.67^a	21.74±1.26^a	3.95±0.72^a	1.04±0.32^a
观察2组	20	84.72±7.27^b	12.56±5.71^b	47.02±1.82^b	15.14±1.04^b	3.94±0.79^b	0.38±0.14^b
F值		0.017	9.987	0.875	30.000	0.169	11.660
P值		0.986	＜0.001	0.387	＜0.001	0.867	＜0.001

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