不同激素治疗小儿急性喉炎并呼吸困难的随机对照研究

Randomized controlled trial on different hormones in treatment of acute laryngitis complicated with dyspnea in children

目的比较不同激素对小儿急性喉炎并呼吸困难的临床疗效。方法将87例急性喉炎并呼吸困难患儿随机分为研究组(n=43)和对照组(n=44)。对照组给予地塞米松雾化吸入,0.3~0.5 mg/(kg·d),研究组给予吸入用布地奈德混悬液雾化吸入,0.5~1 mg/次,2次/d,两组均连续治疗7 d。比较两组临床症状缓解时间及不良反应发生情况、以及临床疗效,比较治疗前后两组血清白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及γ-干扰素(IFN-γ)等炎性因子及免疫球蛋白Ig E水平。结果治疗后,研究组呼吸困难、喘息、声哑、咳嗽、发热及哮鸣音缓解时间均较对照组明显缩短(P<0.01);治疗后,两组IL-6、hs-CRP、IFN-γ及Ig E水平均比治疗前降低(P<0.01),且研究组明显低于对照组(P<0.01);研究组有效率为93.02%明显高于对照组的72.73%(P<0.05)。两组不良反应发生率无明显差异(P>0.05)。结论与地塞米松相比,布地奈德可加速急性喉炎并呼吸困难患儿临床症状的缓解,降低炎性因子和Ig E水平,效果更显著。

Objective To compare the effects of different hormones in the treatment of acute laryngitis complicated with dyspnea in children. Methods A total of 87 children patients with acute laryngitis complicated with dyspnea were randomly divided into a study group （n=43） and a control group （n=44）. The control group was treated with dexamethasone atomized inhalation, 0.3- 0.5 mg/（kg-d） and the study group with budesonide miscible fluid inhalation, 0.5-1 mg/time, twice/d. Both groups were treated for seven consecutive days. The clinical symptom remission time, incidence of adverse reactions and effects between the two groups were compared. The levels of such inflammatory factors as serum interleukin-6 （IL-6）, hypersensitive C-reactive protein （hs-CRP） and γ-interferon （IFN-γ） and the levels of immune globulin IgE before and after the treatment between the two groups were compared. After the treatment, the remission time of dyspnea, wheeze, celostomia, cough, fever and wheezing rale in the study group were significantly shorter than those in the control group （P 〈 0.01）; the IL-6, hs-CRP, IFN-γ and IgE levels in the two groups were lower than those before the treatment （P 〈 0.01）, and the levels in the study group were significantly lower than those in the control group （P 〈 0.01）; the response rate（RR） in the study group was 93.02%, which was much higher than the 72.73% in the control group （P 〈 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P 〉 0.05）. Conclusion Compared with dexamethasone, budesonide can accelerate the remission of the clinical symptoms in children patients with acute laryngitis complicated with dyspnea and lower the levels of inflammatory factors and IgE, and has more significant effects.