布地奈德联合异丙托溴铵雾化治疗小儿支气管肺炎的疗效分析

doi:10.3760/cma.j.issn.1007-1245.2023.23.027

摘要/Abstract

摘要：

目的　探讨布地奈德联合异丙托溴铵雾化治疗小儿支气管肺炎的疗效及对血清白细胞介素（IL）-6、IL-17A水平的影响。方法　本研究为随机对照试验。前瞻性选取徐州医科大学附属徐州市立医院2022年1月至2023年5月收治的106例支气管肺炎患儿，通过信封法将患儿分为两组，每组53例。对照组男29例、女24例，年龄（5.23±1.16）岁，给予布地奈德雾化吸入治疗。观察组男28例、女25例，年龄（5.28±1.21）岁，给予布地奈德+异丙托溴铵雾化吸入治疗。从疗效、临床症状及体征消失时间、免疫功能水平、血清炎症因子水平、血清降钙素原（PCT）水平变化情况及药物的安全性方面对两组患儿进行综合对比。采用独立样本t检验、配对t检验、χ²检验。结果　观察组治疗总有效率高于对照组［96.23%（51/53）比79.25%（42/53）］（χ²=7.102，P=0.008）。观察组的咳嗽、气促、肺部啰音、发热、胸片阴影消失时间均短于对照组（t=17.453、8.190、10.529、10.266、15.488，均P<0.001）。治疗后，两组T淋巴细胞亚群（CD3⁺、CD4⁺及CD8⁺）、炎症因子、PCT水平与治疗前比较差异均有统计学意义（均P<0.05）；观察组的CD3⁺、CD4⁺水平均高于对照组，CD8⁺水平低于对照组，差异均有统计学意义（t=4.614、7.970、9.020，均P<0.001）；观察组各炎症因子水平均低于对照组（均P<0.001）；观察组血清PCT水平低于对照组［（1.12±0.17）µg/L比（2.71±0.23）µg/L］，差异有统计学意义（t=40.472，P<0.001）。观察组不良反应总发生率与对照组比较差异无统计学意义［9.43%（5/53）比7.55%（4/53），χ²=0.121，P=0.727］。结论　小儿支气管肺炎可供选择的治疗方案较多，而选择布地奈德＋异丙托溴铵雾化治疗更具优势，不仅可改善其免疫功能，还可促进患儿肺损伤修复，减轻其炎症反应，促使其各项症状及体征尽快消失，且安全性也有所保障，推广价值高。

关键词:

支气管肺炎, 临床症状, 布地奈德, 异丙托溴铵, 小儿

Abstract:

Objective　To investigate the efficacy of aerosol inhalation of budesonide combined with ipratropium bromide in the treatment of children with bronchopneumonia and its effects on the levels of serum interleukin (IL)-6 and IL-17A. Methods　It was a randomized controlled trial. A total of 106 children with bronchopneumonia admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2022 to May 2023 were prospectively selected as the research subjects and were divided into two groups with 53 cases in each group by the sealed envelope method. In the control group, 29 males and 24 females, aged (5.23±1.16) years, were given budesonide aerosol inhalation therapy. In the observation group, 28 males and 25 females, aged (5.28±1.21) years, were given aerosol inhalation of budesonide + ipratropium bromide. The two groups were compared from the aspects of efficacy, disappearance time of clinical symptoms and signs, changes in immune function, changes in serum inflammatory factor levels, changes in serum procalcitonin (PCT) levels, and drug safety. Independent sample t test, paired t test, and χ² test were used. Results　The total effective rate of the observation group was higher than that of the control group [96.23% (51/53) vs. 79.25% (42/53)] (χ²=7.102, P=0.008). The disappearance time of cough, shortness of breath, pulmonary rales, fever, and chest film shadow in the observation group were shorter than those in the control group (t=17.453, 8.190, 10.529, 10.266, and 15.488, all P<0.001). After treatment, the levels of T lymphocyte subsets (CD3⁺, CD4⁺, and CD8⁺), inflammatory factors, and PCT in the two groups were significantly different from those before treatment (all P<0.05); the levels of CD3⁺ and CD4⁺ in the observation group were higher than those in the control group, and the level of CD8⁺ was lower than that in the control group, with statistically significant differences (t=4.614, 7.970, and 9.020, all P<0.001); the levels of inflammatory factors in the observation group were lower than those in the control group (all P<0.001); the serum PCT level in the observation group was lower than that in the control group [(1.12±0.17) µg/L vs. (2.71±0.23) µg/L], with a statistically significant difference (t=40.472, P<0.001). There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group [9.43% (5/53) vs. 7.55% (4/53), χ²=0.121, P=0.727]. Conclusion　There are multiple treatment options for children with bronchial pneumonia, but the choice of aerosol inhalation of budesonide + ipratropium bromide has distinct advantages, which can improve their immune function, promote the repair of lung injury, reduce their inflammatory response, and promote the disappearance of symptoms and signs as soon as possible, with guaranteed safety and high promotion value.

Key words:

Bronchopneumonia, Clinical symptoms, Budesonide, Ipratropium bromide, Children

陈利娟刘晓丹陈敏姜小花.

布地奈德联合异丙托溴铵雾化治疗小儿支气管肺炎的疗效分析 [J]. 国际医药卫生导报, 2023, 29(23): 3443-3447.

Chen Lijuan, Liu Xiaodan, Chen Min, Jiang Xiaohua.

Therapeutic effect of aerosol inhalation of budesonide combined with ipratropium bromide in the treatment of children with bronchopneumonia [J]. International Medicine and Health Guidance News, 2023, 29(23): 3443-3447.

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