重组人干扰素α2b注射液雾化与阿奇霉素干混悬剂治疗儿童上呼吸道感染和支气管炎的症状缓解时间比较及其影响因素研究

Comparison of Symptoms Remission Time in Treating Children with Upper Respiratory Infection or Bronchitis between Aerosol Treatment of Human Recombinant Interferon-α2b Injection and Azithromycin Suspension,and the Influencing Factors of Symptoms Remission

目的比较重组人干扰素α2b注射液雾化与阿奇霉素干混悬剂治疗上呼吸道感染和支气管炎的症状缓解时间,并分析症状缓解时间的影响因素,为儿科医生有效开展呼吸道疾病诊治工作提供参考。方法选取2010—2015年在上海市博爱医院儿科门诊就诊的上呼吸道感染、支气管炎患儿300例,其中上呼吸道感染患儿154例,采用重组人干扰素α2b注射液雾化治疗患儿87例(A组),采用阿奇霉素干混悬剂治疗患儿67例(B组);支气管炎患儿146例,采用重组人干扰素α2b注射液雾化治疗患儿108例(C组),采用阿奇霉素干混悬剂治疗患儿38例(D组)。检索所有患儿性别、年龄、发热天数、最高体温、咳嗽天数、有痰天数、流涕鼻塞情况、扁桃体红肿情况、干啰音情况、水泡音情况、胃纳、呕吐等临床资料及症状缓解时间并通过医院门诊就诊系统导出数据,上呼吸道感染和支气管炎患儿症状缓解时间影响因素分析采用多元线性回归分析。结果 A组和B组患儿性别、年龄、发热天数、最高体温比较,差异无统计学意义(P>0.05);A组和B组患儿咳嗽天数、有痰天数、流涕鼻塞者所占比例、扁桃体红肿者所占比例、胃纳及恶心比较,差异均有统计学意义(P<0.05)。C组和D组患儿性别、年龄、最高体温、流涕鼻塞者所占比例、扁桃体红肿者所占比例、干啰音者所占比例、胃纳及呕吐比较,差异均无统计学意义(P>0.05);C组和D组患儿发热天数、咳嗽天数、有痰天数及水泡音者所占比例比较,差异均有统计学意义(P<0.05)。A组患儿症状缓解时间短于B组(P<0.001);协方差分析结果显示,控制咳嗽天数、有痰天数、流涕鼻塞、扁桃体红肿、胃纳、呕吐后,A组患儿症状缓解时间短于B组(P<0.01)。C组患儿症状缓解时间短于D组(P<0.001);协方差分析结果显示,控制发热天数、咳嗽天数、有痰天数、水泡音后,C组患儿症状缓解时间短于D组(P<0.01)。多元线性回归分析结果显示,性别、年龄、发热天数、最高体温、咳嗽天数、有痰天数、扁桃体红肿及治疗方法是上呼吸道感染患儿症状缓解时间的影响因素(P<0.05);年龄、发热天数、最高体温、咳嗽天数、流涕鼻塞、扁桃体红肿、呕吐及治疗方法是支气管炎患儿症状缓解时间的影响因素(P<0.05)。结论与阿奇霉素干混悬剂相比,重组人干扰素α2b注射液雾化能有效缩短儿童上呼吸道感染、支气管炎症状缓解时间,但儿童上呼吸道感染、支气管炎症状缓解时间影响因素有一定差异,应加以重视。

Objective To compare the symptoms remission time in treating children with upper respiratory infection or bronchitis between aerosol treatment of human recombinant interferon - α2b injection and azithromycin suspension, to analyze the influencing factors of symptoms remission time to provide references for effective treatment of respiratory disease for paediatricians.Methods A total of 154 children with upper respiratory infection and 146 children with bronchitis were selected in Boai Hospital of Shanghai from 2010 to 2015, there into 87 children with upper respiratory infection received aerosol treatment of human recombinant interferon - α2b （ served as A group） , 67 children with upper respiratory infection received azithromycin suspension （served as B group） , 108 children with bronchitis received aerosol treatment of human recombinant interferon - α2b （ served as C group） , 38 children with bronchitis received azithromycin suspension （ served as D group）. Hospital Outpatient Service System was used to search and derive related data, including gender, age, duration of fever, maximal body temperature,duration of cough, duration of expectoration, proportion of children with stuffy and runny nose, with antiadoncus, with dry rale, with bubble sound, appetite status, emesis status and symptoms remission time. Multiple linear regression analysis was used to analyze the influencing factors of symptoms remission time. Results No statistically significant differences of gender, age, duration of fever or maximal body temperature was found between A group and B group （ P 〉 0. 05 ） , while there were statistically significant differences of duration of cough, duration of expectoration, proportion of children with stuffy and runny nose, antiadoncus and dry rale, appetite status and emesis status between A group and B group （ P 〈 0. 05 ） . No statistically significant differences of gender, age, maximal body temperature, proportion of children with stuffy and runny nose, with antiadoncus, with dry rale, appetite status or emesis status was found between C group and D group, （ P 〉 0. 05 ） , while there were statistically significant differences of duration of fever, duration of cough, duration of expectoration and proportion of children with bubble sound between C group and D group （P 〈0. 0 5 ） . Symptoms remission time of A group was statistically significantly shorter than that of B group （ P 〈 0. 001 ） ; covariance analysis results showed that, symptoms remission time of A group was statistically significantly shorter than that of B group after correction of duration of cough, duration of expectoration, stuffy and runny nose, antiadoncus, appetite status and emesis status （P 〈0. 0 1 ） . Symptoms remission time of C group was statistically significantly shorter than that of D group （ P 〈 0. 001 ） ; covariance analysis results showed that, symptoms remission time of C group was statistically significantly shorter than that of D group after correction of duration of fever, duration of cough, duration of expectoration and bubble sound （ P 〈0. 01 ） . Multiple linear regression analysis results showed that, gender, age, duration of fever, maximal body temperature, duration of cough, duration of expectoration, antiadoncus and therapeutic methods were influencing factors of symptoms remission time in children with upper respiratory infection （P 〈0. 05） ; age, duration of fever, maximal body temperature, duration of cough, stuffy and runny nose, antiadoncus, emesis status and therapeutic methods were influencing factors of symptoms remission time in children with bronchitis （ P 〈 0. 05 ） . Conclusion Compared with azithromycin suspension, aerosol treatment of human recombinant interferon - a2b injection can effectively shorten the symptoms remission time in children with upper respiratory infection or bronchitis, while influencing factors of symptoms remission time of upper respiratory infection and bronchitis are significantly different, which should be pay more attentions to.