摘要
目的:分析布地奈德与特布他林联合甲泼尼龙对大叶性肺炎(Lobar Pneumonia,LP)患儿临床症状及D-二聚体(D-dimer,D-D)水平、肺功能的影响.方法:回顾性收集2022年10月至2023年8月期间在本院就诊的94例LP患儿的临床资料,根据治疗方案分为对照组和观察组(n=47).对照组采用布地奈德(7岁以下100μg·次^(-1)、7岁以上200μg·次^(-1)次,2次·d^(-1))+特布他林(250-500μg·次^(-1),4-6 h·次^(-1))治疗,观察组采用甲泼尼龙联合布地奈德+特布他林治疗,甲泼尼龙(2 mg·kg^(-1)·次^(-1),1次·d^(-1))治疗,布地奈德+特布他林使用方法同对照组.治疗2 w后观察临床疗效、临床症状消失时间,并采用肺功能检测仪检测肺功能,包括达峰时间比(Ratio of time to peak tidal expiratory flow to total expiratory time,TPTEF/TE)、达峰容积比(Ratio of the volume to reach peak tidal expiratory flow to total expiratory volume,VPTEF/VE)、潮气量(Tidal volume,Vt);采用酶联免疫吸附法测定血清白介素-6(Interleukin-6,IL-6)、D-D水平;同时观察不良反应发生情况.结果:观察组的治疗总有效率显著高于对照组(P<0.05).治疗后,观察组的啰音消失时间、肺部阴影吸收时间、退热时间、咳嗽消退时间各项临床症状消失时间均比对照组显著缩短(P<0.05).治疗后,两组的VPTEF/VE、TPTEF/TE、Vt水平均比治疗前显著升高,且观察组的VPTEF/VE、TPTEF/TE、Vt水平均比对照组显著升高(P<0.05).治疗后,两组的D-D、IL-6水平均比治疗前显著降低,且观察组的D-D、IL-6水平均显著低于对照组(P<0.05).两组的不良反应发生率无显著差异(P>0.05).结论:布地奈德与特布他林联合甲泼尼龙治疗LP患儿,能提高疗效,缓解临床症状,调节肺功能,减轻体内炎症反应.
Objective:To analyze the effects of budesonide and terbutaline combined with methylprednisolone on clinical symptoms,D-dimer(D-D)level and lung function in children with Lobar Pneumonia(LP).Methods:Clinical data of 94 children with LP who were treated in our hospital from October 2022 to August 2023 were retrospectively collected.The patients were divided into a control group and an observation group(n=47)according to the treatment plans.The control group was treated with budesonide(100μg·time^(-1) for children under 7 years old,200μg·time^(-1) for children over 7 years old,twice·d^(-1))+terbutaline(250-500μg·time^(-1),4-6 hours·time^(-1)).The observation group was treated with methylprednisolone combined with budesonide+terbutaline.The methylprednisolone(2 mg·kg^(-1)·time^(-1),once·d^(-1))was used,and the budesonide and terbutaline were used in the same way as the control group.After 2 weeks of treatment,the clinical efficacy and the time for clinical symptoms to disappear were observed.Pulmonary function was also assessed using a pulmonary function tester,including Ratio of time to peak tidal expiratory flow to total expiratory time(TPTEF/TE),Ratio of the volume to reach peak tidal expiratory flow to total expiratory volume(VPTEF/VE),and Tidal volume(Vt);the levels of serum Interleukin-6(IL-6)and D-D were measured using Enzyme-linked immunosorbent assay;at the same time,the occurrence of adverse reactions was observed.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the observation group showed significantly shorter clinical symptom disappearance time in terms of the disappearance time of rale,the absorption time of lung shadow,the fever reduction time,and the cough regression time compared with the control group(P<0.05).After treatment,the levels of VPTEF/VE,TPTEF/TE,and Vt in both groups were significantly higher than those before treatment,and the levels of VPTEF/VE,TPTEF/TE,and Vt in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the levels of D-D and IL-6 in both groups were significantly lower than before treatment,and the levels of D-D and IL-6 in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Budesonide and terbutaline combined with methylprednisolone in the treatment of children with LP can improve the efficacy,alleviate clinical symptoms,regulate lung function,and reduce inflammatory reactions in the body.
作者
于明丽
宁红卫
Yu Ming-li;Ning Hong-wei(Department of Pediatrics,People's Hospital of Pingyu,Zhumadian 463400,Henan,China)
