支气管扩张剂对肺炎患儿住院时间及炎症因子的影响研究

Effects of bronchodilators on hospitalization time and inflammatory factors in children with pneumonia

目的探讨支气管扩张剂对肺炎患儿住院时间及炎症因子的影响。方法采用连续抽样法对2017年5月至2018年5月在该院治疗的204例5岁以下肺炎患儿进行横断面研究。并根据治疗方法进行分组:对照组42例(仅采用常规治疗)、治疗A组62例(0.9%NaCl溶液吸入治疗)、治疗B组48例[支气管扩张剂(β受体激动剂——福莫特罗)+0.9%NaCl溶液吸入治疗]和治疗C组52例[支气管扩张剂(β-受体激动剂——福莫特罗)联合抗胆碱剂+0.9%NaCl溶液吸入治疗]。根据治疗时间长短进行分组:长期治疗组112例(治疗时间大于5 d)和短期治疗组92例(治疗时间小于或等于5 d)。监测各组患儿的血液相关炎症因子水平,包括白细胞介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)及降钙素原(PCT),并监测其潮气量(V-T)变化。结果与对照组比较,各治疗组患儿具有更短的住院时间,差异均有统计学意义(P<0.01)。另外,与对照组及治疗A组比较,治疗B、C组长期治疗患儿治疗后相关炎症因子(IL-6、IL-8、TNF-α、hs-CRP及PCT)水平降低程度更高;且与治疗B组比较,治疗C组长期治疗患儿治疗后相关炎症因子水平降低程度更高,差异均有统计学意义(P<0.05)。同时,治疗B、C组长期治疗患儿治疗后V-T显著高于对照组,差异均有统计学意义(P<0.05)。结论采用支气管扩张剂(β-受体激动剂——福莫特罗)能够显著缩短肺炎患儿住院时间,降低血液炎症因子水平,提高V-T水平。且支气管扩张剂联合抗胆碱剂较单纯使用支气管扩张剂对降低患儿炎症因子效果更好。

Objective To investigate the effect of bronchodilators on the hospitalization time and inflammatory factors in children patients with pneumonia.Methods A cross sectional study was conducted on 204 children patients under 5 years old with pneumonia treated in the hospital from May 2017 to May 2018 by adopting the continuous sampling method.According to the treatment methods,the patients were divided into the control group(n=42,adopting the routine treatment only),treatment group A(n=62,inhalation treatment of 0.9%NaCl solution),treatment group B[n=48,inhalation treatment of bronchodilator(beta-receptor agonist——formoterol)+0.9%NaCl solution],and treatment group C(n=52,inhalation treatment of bronchodilator(beta-receptor agonist——formoterol)combined with anticholinergic+0.9%NaCl solution).Meanwhile,the grouping was conducted according to the treatment time:the long term treatment group(n=112,treatment time>5 d)and the short term treatment group(n=92,treatment time≤5 d).Then the levels of blood related inflammatory factors including interleukin-6(IL-6),IL-8,tumor necrosis factor-α(TNF-α),hypersensitive c-reactive protein(hs-CRP)and procalcitonin(PCT)were monitored in each group,and the changes in tidal volume(V-T)were also monitored.Results Compared with the control group,each treatment group had shorter hospitalization stay,and the difference was statistically significant(P<0.01).In addition,compared with the control group and treatment group A,the levels of related inflammatory cytokines(IL-6,IL-8,TNF-αlevels,hs-CRP and PCT)after treatment in the long term treatment children patients of the treatment group B and C had higher decrease degree,moreover compared with the treatment group B,the decrease degree of related inflammatory cytokines levels in the long term treatment children patients of the group C was higher,and the difference was statistically significant(P<0.05).Meanwhile,V-T after treatment in the long term treatment children patients of the group B and C was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Adopting the bronchodilator(β-receptor agonist——formoterol)can significantly shorten the length of hospitalization stay,reduce the level of blood inflammatory cytokines,and increase the V-T level in children patients with pneumonia.Moreover the bronchodilators combined with anticholinergic agents has better effect for reducing the inflammatory factors in children patients than using bronchodilators alone.