摘要
目的探讨布地奈德混悬液和复方异丙托溴铵溶液雾化吸入对肺炎支原体肺炎(MPP)患儿肺功能、炎性因子及预后的影响。方法选择2018年1~12月驻马店市第一人民医院收治的82例MPP患儿为研究对象,根据治疗方法分为观察组和对照组,每组41例。2组患儿均给予常规吸氧、止咳、退热、平喘等常规治疗,对照组患儿在常规治疗基础上给予阿奇霉素治疗,在对照组治疗基础上,观察组患儿给予布地奈德混悬液和复方异丙托溴铵溶液雾化吸入治疗,疗程均为7 d。分别于治疗前后使用肺功能检测仪检测2组患儿肺功能,记录最大呼气量(PEF)、第1秒用力呼气量(FEV1)及用力肺活量(FVC);治疗前后采用酶联免疫吸附试验检测血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)、C反应蛋白(CRP)水平;治疗期间记录2组患儿发热、咳嗽、肺部啰音消退时间,并观察不良反应;2组患儿治疗后进行疗效评估。结果观察组患儿发热、咳嗽及肺部啰音消退时间显著短于对照组(P<0.05)。2组患儿治疗前血清PCT、TNF-α、IL-5及CRP水平比较差异无统计学意义(P>0.05),2组患儿治疗后血清PCT、TNF-α、IL-5及CRP水平显著低于治疗前(P<0.05);治疗后,观察组患儿血清PCT、TNF-α、IL-5及CRP水平显著低于对照组(P<0.05)。2组患儿治疗前PEF、FEV1及FVC比较差异无统计学意义(P>0.05),2组患儿治疗后PEF、FEV1及FVC显著高于治疗前(P<0.05);治疗后,观察组患儿PEF、FEV1及FVC显著高于对照组(P<0.05)。观察组和对照组患儿治疗总有效率分别为97.56%(40/41)、85.37%(35/41),观察组患儿治疗总有效率高于对照组(χ^2=3.905,P<0.05)。观察组和对照组患儿不良反应发生率分别为9.76%(4/41)、12.2%(5/41),2组患儿不良反应发生率比较差异无统计学意义(χ^2=0.125,P>0.05)。结论布地奈德混悬液和复方异丙托溴铵溶液雾化吸入可以有效抑制MPP患儿机体炎症反应,缓解临床症状,改善肺功能,提高治疗效果,且无严重不良反应。
Objective To investigate the budesonide suspension and compound ipratropium bromide solution for inhalation on pulmonary function,inflammatory factors and prognosis of children with mycoplasma pneumoniae pneumonia(MPP).Methods A total of 82 children with MPP admitted to the First People′s Hospital of Zhumadian City from January to December 2018 were selected as the study objects,and they were divided into observation group and control group according to the treatment methods,with 41 cases in each group.The children in the two groups were given oxygen inhalation,cough relieving,pyretolysis,antiasthma and other routine treatment.The children in the control group were treated with azithromycin on the basis of routine treatment,and the children in the observation group were treated with budesonide suspension and compound ipratropium bromide solution for inhalation for 7 days on the basis of the treatment in the control group.The lung function of children in the two groups were detected by lung function detector before and after treatment,and the peak expiratory flow(PEF),forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)were recorded.The levels of serum procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-5(IL-5)and C-reactive protein(CRP)were measured before and after treatment.The subsiding time of fever,cough and lung rale was recorded and the adverse reactions were observed during the treatment period in the two groups.The curative effect of children in the two groups was evaluated after treatment.Results The subsiding time of fever,cough and lung rale of children in the observation group was significantly shorter than that in the control group(P<0.05).There was no significant difference in the levels of serum PCT,TNF-α,IL-5 and CRP between the two groups before treatment(P>0.05).The levels of serum PCT,TNF-α,IL-5 and CRP after treatment were significantly lower than those before treatment in the two groups(P<0.05).The levels of serum PCT,TNF-α,IL-5 and CRP in the observation group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in PEF,FEV1 and FVC of children between the two groups before treatment(P>0.05).The PEF,FEV1 and FVC after treatment were significantly higher than those before treatment in the two groups(P<0.05).The PEF,FEV1 and FVC of children in the observation group were significantly higher than those in the control group after treatment(P<0.05).The total effective rate in the observation group and the control group was 97.56%(40/41)and 85.37%(35/41),respectively;the total effective rate in the observation group was higher than that in the control group(χ^2=3.905,P<0.05).The incidence of adverse reactions in the observation group and the control group was 9.76%(4/41)and 12.2%(5/41),respectively;there was no significant difference in the incidence of adverse reactions between the two groups(χ^2=0.125,P>0.05).Conclusion Budesonide suspension and compound ipratropium bromide solution for inhalation can effectively inhibit the inflammatory response,relieve clinical symptoms,improve lung function and treatment effect in children with MPP,and it have no serious adverse reactions.
作者
张桂欣
ZHANG Gui-xin(Department of Children′s Rehabilitation,the First People′s Hospital of Zhumadian City,Zhumadian 463000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第12期1171-1174,共4页
Journal of Xinxiang Medical University
关键词
肺炎支原体肺炎
布地奈德混悬液
复方异丙托溴铵溶液
肺功能
炎性因子
mycoplasma pneumoniae pneumonia
budesonide suspension
compound ipratropium bromide solution
pulmonary function
inflammatory factor
