不同剂量复方异丙托溴铵雾化吸入对支气管哮喘患儿疗效及心率的影响

Dose-related effects of combined ipratropium bromide and salbutamol inhalation aerosol in children with bronchial asthma on therapeutic efficacy and heart rate

目的探讨不同复方异丙托溴铵雾化吸入对支气管哮喘患儿疗效及心率的影响。方法选择我院儿科于2014年6月至2016年6月期间收治的84例支气管哮喘患儿,根据随机数字表法分为A、B、C三组,每组28例,所有患儿均接受雾化吸入复方异丙托溴铵治疗,剂量分别为每次1 m L、1.25 m L、2.5 m L,疗程7 d;比较三组患儿的临床疗效及首次用药后的心率情况。结果 A组患儿的治疗总有效率为71.43%,明显低于B组的89.29%和C组的96.43%,差异均有统计学意义(P<0.05),而B组和C组的疗效比较差异无统计学意义(P>0.05);在治疗后5 min、20 min,心率在三组均较治疗前显著加快,且在A组、B组、C组间分别为(108.5±9.6)次/min和(104.8±7.5)次/min、(117.2±8.9)次/min和(110.5±8.1)次/min、(124.8±9.2)次/min和(126.6±9.7)次/min,两两比较均依次上升,差异有统计学意义(P<0.05);A组与B组心率恢复正常时间分别为(21.6±6.2)min、(24.4±6.8)min,差异无统计学意义(P>0.05)。结论复方异丙托溴铵雾化吸入治疗儿童支气管哮喘急性发作具有较好的临床疗效,选择1.25 m L的中剂量复方异丙托溴铵雾化吸入治疗可以在保证疗效的前提下减少对患儿心率的影响。

Objective To explore the dose-related effects of combined ipratropium bromide and salbutamol inhalation aerosol in children with bronchial asthma on therapeutic efficacy and heart rate. Methods A total of 84 children with bronchial asthma hospitalized in our hospital＇s Department of Pediatrics from June 2014 to June 2016 were randomly divided into A, B, C groups（28 cases in each group） according to the random number table method, who were treated with ipratropium bromide/salbutamol through inhaling at different dosage（1 m L, 1.25 m L, 2.5 m L per time, respectively） via nebulizer for 7 days. The therapeutic efficacy and the heart rate of first drug use were compared among three groups. Results The total effective rate of A group was 71.43%, significantly lower（P〈0.05） than that of B group（89.29%） and C group（96.43%）; while no significant difference was found between B group and C groups（P〉0.05）. Ipratropium bromide/salbutamol inhalation for 5 min and 20 min increased the heart rate significantly than before treatment in all three groups. Mean heart rate after treatment were（108.5 ± 9.6） times/min and（104.8 ± 7.5） times/min in A group,（117.2±8.9） times/min and（110.5±8.1） times/min in B group,（124.8±9.2） times/min and（126.6±9.7） times/min in C group; there were significant differences found in all the paired groups（P〈0.05）. The heart rate recovery time of A group and B group were（21.6 ± 6.2） min and（24.4 ± 6.8） min, respectively, with no significant difference between groups（P〉0.05）. Conclusion Ipratropine bromide and salbutamol inhalation has better clinical efficacy in the treatment of children with acute bronchial asthma. Based on the premise of ensuring the curative effect, a medium-dose（1.25 m L） of ipratropine bromide and salbutamol inhalation treatment can reduce the effect on heart rate in children.