阿奇霉素、β2受体兴奋剂联合糖皮质激素吸入治疗支原体感染引发小儿哮喘的临床效果研究

Study on the clinical efficacy of azithromycin and β2 receptor stimulant combined with glucocorticoid inhalation in treatment of pediatric asthma caused by mycoplasmal infection

目的 探讨阿奇霉素与特布他林联合布地奈德吸入治疗支原体（MP）感染导致小儿哮喘的临床疗效。方法选取2014-2016年住院治疗的400例MP感染导致哮喘患儿,随机分为两组,对照组患儿以阿奇霉素与特布他林联合至,研究组患儿增加布地奈德吸入。比较两组临床疗效、治疗过程中的呼吸最大峰流速、咳嗽消失时间、平均住院时间、持续给药3天后的临床症状情况与MP-Ig M抗体指标,以及随访3个月内的复发率、复发时间。结果 治疗结束后研究组患儿总有效率（89.0%）明显高于对照组（76.0%）,差异有显著性（P〈0.05）。研究组患儿最大峰流速（92.7±2.7 L/min）、咳嗽消失时间（5.4±1.7 d）、住院时间（6.1±1.8 d）、治疗3天后患儿发热（14.5%）、肺部哮鸣音（10.5%）以及啰音（12.5%）发生率相比对照组（82.4±3.4 l/min,8.6±1.3 d,9.2±1.5 d,32.5%,32.5%,30.5%）均明显改善,差异有显著性（P〈0.05）。随访3个月内,研究组的复发时间（24.7±4.3 d）明显长于对照组（12.5±3.7 d）,差异有显著性;复发率（6.5%）低于对照组（18.5%）,但差异无显著性（P〉0.05）。结论 阿奇霉素与特布他林联合布地奈德吸入治疗MP感染导致小儿哮喘,能够有效提高临床疗效,改善临床症状以及指标,延长复发时间。

Objective To explore the clinical efficacy of azithromycin and β2 receptor stimulant combined with glucocortion in treatment of patients with pediatric asthma caused by mycoplasmal infection. Methods Four hundred pediatric patients with asthma caused by MP infection treated during 2014 to 2016 were selected, and they were randomly divided into two groups. Patients in control group were treated with azithromycin combined with inhalation of terbutaline, and patients in study group were treated with glucocorticoid inhalation based on the treatment of control group. The clinical efficacy, the maximum breathing peak flow, the duration for disappearance of coughing, the average duration of hospital stay, changing in clinical symptoms and MP - IgM antibody indicators after taking medicine for 3 days, the recurrence rate and recurrence time during the follow up periods of two groups were compared. Results After treatment, the total effective rate （89. 0% ） of study group was evidently higher than that of control group （76. 0% ） , and the difference was significant （ P 〈 0. 05）. The maximum peak flow （92？ 7 ± 2. 7 L/min） , the duration of disappearance of coughing （5.4±1.7 d）, the length of hospital stay （6.1 ±1.8 d） and the incidence rate of fever （14. 5% ） , the wheezing sound （10. 5% ） and rales （12. 5% ） in lungs （10. 5% ） after treatment for 3 days in the study group were evidently improved compared with those of the control group （82.4 ±3.4 L/min, 8.6 ±1.3 d, 9. 2 ± 1 .5 d, 32. 5% , 32.5% , 30.5% ） , and the difference was significant （ P 〈 0. 05）. During the three - month follow - up period,the recurrence time of the study group （24.7 ±4.3 d） was evidently longer than that of the control group （12. 5 ±3.7 d）,which had significant difference. The recurrence rate of the study group （6.5%） was lower than that of the control group （18.5%）, but the difference was not significant （ P 〉 0 .0 5 ） . Conclusion Azithromycin and p2 receptor stimulant combined with glucocorticoid inhalation in treatment of pediatric asthma caused by mycoplasmal infection can effectively raise the clinical efficacy, but it can also improve the clinical symptoms and indicators, and extend the recurrence time.