布地奈德吸入治疗对毛细支气管炎患儿肺功能和氧化应激的影响

Effect of budesonide inhalation therapy on pulmonary function and oxidative stress of children with bronchiolitis

目的观察布地奈德吸入治疗前后毛细支气管炎患儿肺功能和氧化应激的变化,为毛细支气管炎的治疗提供实验室依据。方法选择80例毛细支气管炎患儿随机分为观察组和对照组各40例,两组患儿均给予综合治疗,观察组患儿加用布地奈德雾化吸入,于治疗前及治疗1月后测定肺功能、血清丙二醛(MDA)及超氧化物歧化酶(SOD)水平。另选取40例正常儿童为健康组。肺功能主要参数为潮气量(TV),呼吸频率(RR),达峰时间比(TPTEF/TE)和达峰容积比(VPTEF/VE)。结果治疗前观察组与对照组肺功能比较差异无统计学意义(P>0.05),但两组与健康组比较差异有统计学意义(P<0.01)。两组毛细支气管炎患儿治疗后肺功能较治疗前明显改善,差异有统计学意义(P<0.01);治疗后观察组TPTEF/TE和VPTEF/VE明显高于对照组,差异有统计学意义(P<0.01)。治疗前两组毛细支气管炎患儿血清SOD水平明显低于健康组,MDA明显高于健康组,差异有统计学意义(P<0.05);治疗前、后SOD及MDA水平比较差异无统计学意义(P>0.05)。结论毛细支气管炎患儿存在氧化应激,布地奈德可改善患儿肺功能,但对氧化应激无影响。

Objective To observe the changes of pulmonary function and oxidative stress of children with bronchiolitis before and after budesonide inhalation therapy, provide a laboratory basis for treatment of bronchiolitis. Methods Eighty children with bronchiolitis were randomly divided into observation group and control group equally. The children in the two groups were treated by comprehensive therapy, the children in observation group were treated by budesonide inhalation therapy. Pulmonary function, serum malondialdehyde （MDA） and superoxide dismutase （SOD） levels before treatment and after one month of treatment were detected. Forty normal children were selected as healthy group. The main parameters of pulmonary function included tidal volume （ TV ） , respiratory rate （RR） , the ratio of time to peak tidal expiratory flow （tPTEF） to total expiratory time （TE） （tPTEF/TE）, and volume ratio of peak-TEF in volume of expiration （VPTEF/ VE） . Results Before treatment, there was no statistically significant difference in pulmonary function between observation group and control group （ P〉0.05 ） , but there was statistically significant difference between the two groups and healthy group （ P〈0.01 ） . In observation group and control group, pulmonary functions after treatment were improved compared before treatment, there were statistically significant differences （P〈0. 01 ） . After treatment, TPTEF/TE and VPTEF/VE in observation group were statistically significantly higher than those in control group （P〈0. 01 ） . Before treatment, serum SOD levels in observation group and control group were statistically significantly lower than those in healthy group （P〈0. 05 ）, serum MDA levels in observation group and control group were statistically significantly higher than those in healthy group （P〈0. 05） . There was no statistically significant difference in SOD and MDA levels between before and after treatment （P〉0. 05） . Conclusion Oxidative stress exists in children with bronchiolitis. Budesonide can improve pulmonary function of the children, but it has no effect on oxidative stress.