沙丁胺醇、布地奈德辅助雾化吸入治疗小儿哮喘合并呼吸道病毒感染的疗效

Effect of nebulized salbutamol and budesonide as an add-on therapy in asthmatic children with respiratory viral infection

目的:探讨沙丁胺醇、布地奈德辅助雾化吸入治疗小儿哮喘合并呼吸道病毒感染的疗效及对气道重塑和炎性反应的影响。方法:收集2018年2月至2019年2月本院收治的哮喘合并呼吸道病毒感染患儿95例,按随机数字法分为对照组(n=47)和观察组(n=48),对照组给予常规对症综合治疗,观察组在对照组基础上给予沙丁胺醇、布地奈德辅助雾化吸入治疗。比较两组的治疗情况和临床疗效。比较两组血清组织型基质金属蛋白酶抑制剂1(TIMP-1)、基质金属蛋白酶9(MMP-9)、转化生长因子β(TGF-β)、C反应蛋白(CRP)、白细胞介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)及免疫球蛋白水平。结果:观察组咳嗽、呼吸困难、哮鸣音及肺部啰音消失时间均短于对照组(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗2个月后进行疗效评价,观察组治疗有效率显著高于对照组(91.7%比72.3%,χ^2=6.037,P<0.05)。治疗后观察组血清TIMP-1、MMP-9、TGF-β、CRP、TNF-α、IL-6及IL-8水平均显著低于对照组,而免疫球蛋白A(IgA)、IgG水平显著高于对照组(均P<0.05)。结论:沙丁胺醇、布地奈德辅助雾化吸入治疗小儿哮喘合并呼吸道病毒感染疗效显著,可改善气道重塑和减轻炎症反应。

Objective:To investigate the clinical efficacy of nebulized salbutamol and budesonide as an add-on therapy and their effect on airway remodeling and inflammatory response in asthmatic children with respiratory viral infection.Methods:Ninety-five children with asthma complicated with respiratory viral infection in our hospital between February 2018 and February 2019 were selected and divided into the control group(n=47)and study group(n=48)by random number table.The control group was given conventional symptomatic comprehensive treatment;in addition to this,the study group was given nebulized salbutamol and budesonide as an add-on therapy.The clinical course,treatment efficacy,serum levels of tissue inhibitor of metalloproteinase-1(TIMP-1),matrix metalloproteinase-9(MMP-9),transforming growth factor-β(TGF-β),C-reactive protein(CRP),interleukin-6(IL-6),IL-8,tumor necrosis factor-α(TNF-α),and immunoglobulins were compared between the two groups.Results:The study group experienced shorter time to resolution of cough,dyspnea,wheezing and pulmonary rales compared with the control group(all P<0.05).There was no signficant difference in adverse reaction between groups(P>0.05).At two months of treatment,the rate of response was higher in the study group than that in the control group(91.7%vs 72.3%,χ^2=6.037,P<0.05).After treatment,the study group showed higher IgA and IgG levels,whereas lower TIMP-1,MMP-9,TGF-β,CRP,TNF-α,IL-6 and IL-8 levels,compared with the control group(all P<0.05).Conclusion:Nebulized salbutamol and budesonide as an add-on therapy leads to remarkable treatment efficacy and improves airway remodeling and inflammatory response in asthmatic children with respiratory viral infection.