不同剂量干扰素雾化吸入治疗小儿毛细支气管炎的近期疗效及不良反应观察

Influence of different doses of interferon atomization inhalation on the short - term clinical efficacy, lung function and adverse effects in children with bronchiolitis

目的探讨常规剂量与大剂量干扰素雾化吸入对小儿毛细支气管炎患儿近期疗效、肺部通气功能及不良反应的影响。方法研究对象选取小儿毛细支气管炎患儿共160例，采用随机数字表法分为A组（80例）和B组（80例），分别在沙丁胺醇给药基础上加用干扰素20万IU·kg^-1·d^-1和40万IU·kg^-1·d^-1雾化吸入治疗；比较两组近期疗效、症状体征消失时间、住院时间、治疗前后病情严重程度评分、呼吸频率（RR）、血氧饱和度（SpO：）水平及不良反应发生率等。结果A组、B组患儿治疗显效率分别为27．50％、40．00％；A组、B组患儿治疗总有效率分别为81．25％、95．00％；B组患儿治疗显效率和总有效率较A组均显著提高（x2=7．27，P〈0．05）；B组患儿症状体征消失和住院时间较A组均显著缩短（t=2．78、2．65、3．04、2．19，均P〈0．05）；B组患儿治疗后病情严重程度评分较A组、治疗前均显著降低（t=2．43、2．13、2．55、2．07；3．02、3．41；3．11、3．65；2．81、3．30；2．87、3．15，均P〈0．05）；B组患儿治疗后肺部通气功能指标水平较A组、治疗前均显著改善（t=2．35、2．20、2．73、3．04；2，49、2．97，均P〈0．05）；同时两组不良反应发生率差异无统计学意义（X2=1．26，P〉0．05）。结论相较于常规剂量干扰素，大剂量干扰素雾化吸入治疗小儿毛细支气管炎可有效提高病情控制效果，加快疾病康复进程，改善肺部通气功能，且未加重药物不良反应。

Objective To investigate the influence of conventional and high dose of interferon atomization inhalation on the short - term clinical efficacy, lung function and adverse effects of children with bronehiolitis. Methods 160 children with bronchiolitis were chosen and randomly divided into two groups ,80 cases in each group. On the basis of salbutamol inhalation, A group was given recombinant interferon α -2b for 200 000 IU·kg^-1·d^-1, and B group was given recombinant interferon α - 2b for 400 000 IU·kg^-1·d^-1. The short - term clinical efficacy, the disappeared time of symptoms and signs, the hospital staying time, the disease severity score, the levels of RR and SpO2 before and after treatment and the incidence of adverse effects were compared between the two groups. Results The excellence effects and total clinical effects of B group were significantly higher than those of A group（x2 =7.27, P 〈 0.05 ）. The disappeared time of symptoms and signs and hospital staying time of B group were significantly shorter than those of A group（ t = 2.78,2.65.3.04,2.19, all P 〈 0.05 ）. After treatment, the disease severity scores of B group were significantly lower than those of A group and before treatment（ t = 2.43,2.13,2.55,2.07 ;3.02,3.41 ; 3. 11,3.65 ;2.81,3.30 ;2.87,3.15 ; all P 〈 0.05 ）. After treatment, the indicators of pulmonary ventilation function of B group were significantly lower than those o1 A group and before treatment（ t = 2.35,2.20,2.73,3.04 ;2.49,2.97, all P 〈 0.05 ）. There was no statistically significant difference in the incidence rate of adverse effects between the two groups（ X2 = 1.26, P 〉 0.05 ）. Conclusion Compared with conventional dose of interferon, high dose interferon atomization inhalation in the treatment of children with bronchiolitis can effectively higher the disease control effects, speed up the disease rehabilitation process, improve the pulmonary ventilation function and without aggravate drug adverse reactions.