吸入糖皮质激素干预毛细支气管炎后喘息的临床分析

Clinical analysis of glucocorticoids inhalation in preventing asthma attack after bronchiolitis

目的:观察吸入糖皮质激素对预防毛细支气管炎(毛支)后喘息发作的疗效。方法:选择64例毛支患儿,随机分成两组,治疗组(34例)采用常规治疗+吸入β2受体激动剂+吸入糖皮质激素(布地奈德)4周,对照组采用常规治疗+吸入β2受体激动剂,检测治疗前后睡眠时的潮式呼吸肺功能,观察并对比急性期治疗效果及病后1年内喘息发生情况。结果:治疗组雾化吸入治疗前后潮式呼吸的各项参数均有明显改变(P<0.05),对照组潮式呼吸参数TPTEF/TE、VPEF/VE治疗前后相比差异有统计学意义(P<0.05);治疗组治疗后比较,Crs与Rrs发生明显变化(P<0.05)。治疗组急性期显效率明显高于对照组(P<0.01);病后1年内治疗组患儿喘息发生例数及平均发作次数较对照组明显减少(P<0.01)。结论:吸入糖皮质激素(布地奈德)治疗毛细支气管炎可明显改善肺功能,迅速缓解急性期喘息症状,明显减少病后1年内喘息发作,降低哮喘发病率,值得临床推广应用。

Objective： To evaluate the theraputie effect of glueoeorticoids inhalation in preventing asthma attack after bronehiolitis. Methods： 64 infants were randomly divided into two groups： the treating group （34 cases） was treated with regular therapy and inhalation of β2 adrenoceptor agonisls for one week and paimieort respules for 4 weeks and the control grnup was treated with regular treatment and inhalation of β2. adrenoeeptor agonists. Using MS-PEADTRIC PF determir to delermine respiratory pulmonary function of Cheyne-stokes· breathing, respectively before and after treatment during sleeping. The therapeutic effect in acute attack of bronehiolitis and asthma attack 1 year after the treatment were observed and compared. Results： The parameters of Cheyne-stokes breathing before and after aerial therapy significantly change in treating group （P 〈 0.115）. TPTEF/TE and VPEF/VE of control group significantly changed （ P 〈 0.05 ） and there was a statistic difference. But there is no statistical significance in Crs and Rrs （ P 〉 0.05） . The changes of Crs and Rrs after treatment were obvious with a significant difference （ P 〈 0.05）. The most effective rate of treating group was higher than the control group during acute periods （P 〈 0.01 ）. The asthma eases and average attacks of treating group during I year after treatment were less than the control group. There was a statistleal significance （ P 〈 0.001）. Conclusions： The glueoeortieoid inhalation treatment can significantly improve pulmonary function and relax the asthma symptoms at acute stage of bronehiolitis. It obviously reduces the recurrences of asthma attacks within one year after bronehiolitis. So it deserves to be performed in more patients.