摘要
目的:分析布地奈德联合乳糖酸红霉素治疗类百日咳综合征的效果及安全性。方法:选取2019年8月至2023年11月期间于本院诊疗的类百日咳综合征患儿98例作为研究对象。随机将患儿分为对照组和观察组,每组各49例。对照组予以乳糖酸红霉素治疗;观察组予以布地奈德联合乳糖酸红霉素治疗。分析比较两组的临床疗效、T细胞淋巴亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、潮气呼吸功能[达峰时间比(Ratio of time to peak tidal expiratory flow to total expiratory time,TPTEF/TE)、吸呼时间比(Aspiratory to expiratory ratio,TI/TE)、达峰容积比(Ratio of the volume to reach peak tidal expiratory flow to total expiratory time,VPEF/VE)、潮气量(Tidal volume,VT)、呼吸频率(Respirator Rate,RR)]、血清炎性因子[C-反应蛋白(C-reaction protein,CRP)、白介素-4(Inter-leukin-4,IL-4)、白介素-6(Interleukin-6,IL-6)]水平及不良反应发生率。结果:观察组的治疗临床总有效率明显高于对照组(P<0.05)。与治疗前相比,治疗14 d后两组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均呈升高趋势,且观察组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显高于对照组(P<0.05)。治疗14 d后,观察组的VT、TPTEF/TE、TI/TE、VPEF/VE水平均明显高于对照组,RR水平明显低于对照组(P<0.05)。治疗14 d后,两组的血清IL-4、CRP、IL-6水平均显著降低(P<0.05);且观察组的血清IL-4、CRP、IL-6水平均明显低于对照组(P<0.05)。两组的不良反应发生率无显著差异。结论:布地奈德联合乳糖酸红霉素治疗类百日咳综合征,能提高疗效,调节T细胞淋巴亚群,改善潮气呼吸功能,抑制体内炎性反应,且安全性较高。
Objective:To analyze the efficacy and safety of budesonide combined with erythromycin lactobionate in the treatment of pertussis-like syndrome.Methods:98 children with pertussis-like syndrome treated in our hospital from August 2019 to November 2023 were selected as the study objects.The children were randomly divided into control group and observation group,with 49 cases in each group.The control group was treated with erythromycin lactobionate.Observation group was treated with budesonide combined with erythromycin lactobionate.The clinical efficacy,T cell lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),moisture respiratory function[Peak time ratio(TPTEF/TE),breathing-to-breathe ratio(TI/TE),peak-to-volume ratio(VPEF/VE),tidal volume(VT),respiratory rate(RR)]and the levels of serum inflammatory factors[C-reactive protein(CRP),interleukin-4(IL-4),interleukin-6(IL-6)]and the incidence of adverse reactions were analyzed and compared between the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Compared with before treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were increased after 14 days of treatment,and the levels of these parameters in the observation group were significantly higher than those in the control group(P<0.05).After 14 days of treatment,the VT,TPTEF/TE,TI/TE and VPEF/VE levels in observation group were significantly higher than those in control group,and the RR level was significantly lower than that in control group(P<0.05).After 14 days of treatment,the serum levels of IL-4,CRP and IL-6 in both groups were significantly decreased(P<0.05).The levels of IL-4,CRP 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.Conclusion:Budesonide combined with erythromycin lactobionate in the treatment of pertussis syndrome can improve the efficacy,regulate T cell lymphocyte subsets,improve moisture respiratory function,inhibit inflammatory response in vivo,and have high safety.
作者
于维波
Yu Wei-bo(Department of Pediatrics,Qinyang People's Hospital,Qinyang 454550,Henan,China)
