目的 探討靜注人免疫球蛋白（pH 4）聯(lián)合注射用更昔洛韋治療小兒腺病毒肺炎的臨床療效。方法 選擇2014年6月—2016年12月華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬武漢兒童醫(yī)院收治的腺病毒肺炎患兒90例，所有患兒按隨機(jī)數(shù)字表法隨機(jī)分為對(duì)照組和治療組，每組各45例。對(duì)照組靜脈滴注注射用更昔洛韋，5 mg/kg，滴注時(shí)間> 1 h，2次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注靜注人免疫球蛋白（pH 4），400 mg/kg，1次/d。兩組患兒均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組的臨床癥狀、腫瘤壞死因子-α（TNF-α）、分泌型磷脂酶A2（sPLA2）、克拉拉細(xì)胞分泌蛋白（CCSP）和白細(xì)胞介素-1（IL-1）水平情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為71.11%、95.56%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）。治療后，治療組退熱時(shí)間、咳嗽停止時(shí)間、咽痛消失時(shí)間、肺部濕啰音消失時(shí)間和住院時(shí)間均明顯短于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）。治療后，兩組血清TNF-α、sPLA2、CCSP和IL-1水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）。結(jié)論 靜注人免疫球蛋白（pH 4）聯(lián)合注射用更昔洛韋治療小兒腺病毒肺炎具有較好的臨床療效，可改善臨床癥狀，降低TNF-α、sPLA2、CCSP和IL-1水平，具有一定臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Human Immunoglobulin (pH 4) for intravenous injection combined with Ganciclovir for injection in treatment of adenoviral pneumonia in children. Methods Children (90 cases) with adenoviral pneumonia in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology from June 2014 to December 2016 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Ganciclovir for injection, 5 mg/kg, infusion time > 2 h, twice daily. Patients in the treatment group were iv administered with Human Immunoglobulin (pH 4) for intravenous injection on the basis of the control group, 400 mg/kg, once time. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptom, TNF-α, sPLA2, CCSP, and IL-1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.11% and 95.56%, respectively, and there was difference between two groups (P < 0.05). After treatment, pyretolysis time, cough stop time, sore throat disappear time, lung wet rales disappearance time, and hospitalization time in the treatment group were shorter than those in the control group, and there was difference between two groups (P < 0.05). After treatment, the levels of TNF-α, sPLA2, CCSP, and IL-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Human Immunoglobulin (pH 4) for intravenous injection combined with Ganciclovir for injection has clinical curative effect in treatment of adenoviral pneumonia in children, can improve clinical symptoms, and decrease the levels of TNF-α, sPLA2, CCSP, and IL-1, which has a certain clinical application value.