N-乙酰半胱氨酸辅助治疗新生儿支气管肺炎疗效及对血清炎性指标的影响

Effect of N - acetylcysteine in adjunctive treatment of neonatal bronchopneumonia and its influence on serum inflammatory factors

目的探讨N-乙酰半胱氨酸（NAC）辅助治疗新生儿支气管肺炎的临床疗效以及对血清炎性指标的影响。方法将2012年6月至2014年12月收治的62例新生支气管肺炎患儿采用数字表法随机分为观察组（32例）与对照组（30例）。对照组给予抗感染、止咳平喘、退热、吸氧、保持呼吸道通畅以及营养支持等基础治疗，观察组在此基础上给予NAC雾化治疗。比较两组疗效，并观察两组体温恢复正常平均时间，咳嗽、气促、肺部哕音等临床症状消失时间以及平均住院时间，并于住院治疗前后检查两组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）、IL-6、IL-10水平。结果观察组总有效率为90．63％，高于对照组的70．00％（X2=4．220，P〈0．05）；观察组体温恢复正常平均时间，咳嗽、气促、肺部哕音临床症状消失时间以及平均住院时间均短于对照组（t=-4．211、-3．472、-4．240、-5．413、-7．822，均P〈0．05）；治疗后，观察组血清TNF-α、IL-1、IL-6、IL-10表达水平明显低于对照组（t=-6．421、-3．892、-15．452、-9．773，均P〈0．05）。结论NAC雾化吸入辅助治疗新生儿支气管肺炎能有效提高临床治疗效果，缩短病程，并通过调节炎性介质表达水平，减轻全身炎性反应对各器官的损伤，促进患儿尽快恢复。

Objective To explore the effect of N -acetylcysteine（NAC） in adjunctive treatment of neonatal bronchopneumonia and its influence on serum inflammatory factors. Methods 62 neonatus with bronchopneumonia treated in our hospital from June 2012 to December 2014 were randomly divided into observation group（ 32 cases） and control group（30 cases） with random number table. The control group was treated with basic therapy, such as relieving a cough and asthma, defervescing, oxygen inhalation, keeping respiratory tract unobstructed, nutritional support, while the observation group was added aerosol inhalation of NAC on the basis of basic therapy. Then the effect of the average time of body temperature returned to normal,the disappearance time of cough,asthma and pulmonary rale,and average hospitalization days of two groups were observed and compared, the levels of serum tumor necrosis factor -α（ TNF - α）, interleukin - 1 （ IL - 1 ）, interleukin - 6 （ IL - 6 ） and interleukin - 10 （ IL - 10 ） of the two groups before and after treatment were detected. Results The total effective rate of the observation group was 90.63%, which was higher than 70% of the control group （ ~2 = 4. 220, P 〈 0.05 ）. The average time of body temperature returned to normal, disappearance time of cough asthma and pulmonary rale, and average hospitalization days of the observation group were shorter than those of the control group （t = -4. 211, -3. 472, -4. 240, -5. 413, -7. 822, all P 〈 0.05）. The levels of serum TNF - α,IL - 1 ,IL -6 and IL - 10 of the observation group after treatment were lower than those of the control group （t = - 6.421, - 3. 892, - 15. 452, - 9. 773, all P 〈 0.05 ）. Conclusion Using aerosol inhalation of NAC in adjunctive treatment of neonatal bronchopneumonia can significantly improve the clinical effect and shorten the course of disease, meanwhile, it will eases the systemic inflammatory response to damage the organs by regulating the level of inflammatory factors, which is good for the recover of neonatus as soon as possible.