支气管哮喘并结核感染儿童的临床治疗

Clinical Treatment of the Asthma Children with Tuberculosis Infection

目的探讨支气管哮喘合并结核感染的患儿吸入性糖皮质激素的临床效果。方法选取佛山市高明区人民医院2009年3月至2011年8月收治的支气管哮喘合并结核感染的42例患儿作为观察组,以同期未合并结核感染患儿45例作为对照组。两组均给予布地纳德吸入治疗,急性发作时加用沙丁胺醇,病情较重时给予甲泼尼龙或泼尼松治疗。观察组同时进行抗结核治疗。结果观察组治疗3个月、6个月的沙丁胺醇平均用量显著少于对照组(P<0.05)。治疗6个月期间两组急诊次数比较差异有统计学意义(P<0.05)。对照组住院次数稍多于观察组,但差异无统计学意义(P>0.05)。治疗6个月后两组各肺功能指标用力肺活量、用力呼气量、第一秒用力呼气量/用力肺活量和呼气流量峰值均有明显改善(P<0.05)。但观察组各肺功能指标改善较对照组更明显。结论结核感染提高了吸入类激素药物治疗支气管哮喘的临床疗效。哮喘患儿人工结核感染可能为防治支气管哮喘提供了一种新方法与新思路。

Objective To explore ）the effect of inhaled corticosteroids on tuberculosis （ TB ） infection in asthma children. Methods A total of 42 children with asthma combined with TB infection were enrolled as the observation group,45 children with asthma without TB infection were enrolled as control group. All asthma children were treated with budesonide inhalation, salbutamol was added for acute asthma attack, and methylprednisolone or prednisone was given in serious situation. Meanwhile children in the observation group were treated with anti-TB drugs additionally. Results After treatment for 3 months and 6 months, the average amount of salbutamol in the observation group was significantly less than the control group（ P 〈 0.05 ）. During the 6 months of treatment there was significant difference in emergency visits（ P 〈 0.05 ）. Hospitalization time was slightly more in the control group than the observation group, but there was not statistically signficant difference（ P 〉 0.05 ）. After 6 months of treatment, the lung function parameters FVC, FEV, FEV1/ FVC and PEF were significantly improved in the two groups（ P 〈0.05 ）. However,the lung function parame ters in the observation group improved more significantly than the control group （ P 〈 0.05 ）. Conclusion The clinical efficacy of inhaled corticosteroids an children with asthma and TB infection is better than those without TB infection. The method of purposive TB infection as adjuvant treatment of asthma in children might be a new way and idea of asthma treatment and prevention.