硫酸沙丁胺醇联合不同剂量布地奈德混悬液雾化吸入治疗小儿支气管哮喘合并肺炎支原体感染的临床观察

Clinical Observation on Salbutamol Sulfate Combined with Different Doses of Budesonide Suspension for Aerosol Inhalation in the Treatment of Pediatric Bronchial Asthma Combined with Mycoplasma Pneumoniae Infection

目的:探讨硫酸沙丁胺醇联合不同剂量布地奈德混悬液雾化吸入治疗小儿支气管哮喘合并肺炎支原体感染的临床效果。方法:选取本院2017年9月~2018年10月99例小儿支气管哮喘合并肺炎支原体感染患者,随机均分为高剂量组、中剂量组及低剂量组,每组各33例。三组患儿均给予硫酸沙丁胺醇与不同剂量布地奈德混悬液雾化吸入治疗,其中高剂量组患儿布地奈德给药剂量2.0 mg/d、中剂量组1.0 mg/d、低剂量组0.5 mg/d,比较3组患儿临床疗效、临床症状好转时间、通气功能指标、痰液指标水平以及不良反应发生情况。结果:高剂量组临床治疗有效率(93.94%)与中剂量组(90.91%)比较无统计学差异;高剂量组与中剂量组临床治疗有效率均高于低剂量组72.73%(P<0.05);高剂量组患儿呼吸困难消失时间、咳嗽缓解时间、肺部啰音消失时间、肺部哮鸣音消失时间、住院时间短于中剂量组,中剂量组症状改善时间短于低剂量组(P<0.05);高剂量组治疗后用力肺活量(FVC)、一秒用力呼气容积(FEV 1)、FEV 1占预计值百分比(FEV 1%)、最大呼气流速峰值(PEF)高于中剂量组与低剂量组(P<0.05);高剂量组治疗后痰液中白介素-4(IL-4)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平低于中剂量组与低剂量组(P<0.05);三组不良反应发生率比较无统计学差异。结论:硫酸沙丁胺醇联合高剂量布地奈德混悬液雾化吸入治疗肺炎支原体感染疗效显著,可有效改善患儿临床症状。

Objective:To explore clinical effects of salbutamol sulfate combined with different doses of budesonide suspension for aerosol inhalation on children with bronchial asthma combined with mycoplasma pneumoniae(MP)infection.Methods:99 children diagnosed with bronchial asthma combined with MP infection in the hospital from September 2017 to October 2018 were enrolled in this study.They were randomly divided into high-dose,middle-dose and low-dose groups,33 cases in each group.The three groups were given salbutamol sulfate and different doses of budesonide suspension for aerosol inhalation(high:2.0 mg/d,middle:1.0 mg/d,low:0.5 mg/d).The clinical curative effect,time for clinical improvement,ventilation function indexes,levels of sputum indexes and occurrence of adverse reactions were compared among the three groups.Results:There was no significant difference in response rate of clinical treatment between high-dose group and middle-dose group(93.94%vs 90.91%).The response rates of clinical treatment in high-dose group and middle-dose group were higher than that in low-dose group(72.73%,P<0.05).The time of dyspnea,cough,lung rale,lung wheezing rale,and hospitalization in high-dose group were shorter than those in middle-dose group.The symptom improvement time in middle-dose group was shorter than that in low-dose group(P<0.05).After treatment,forced vital capacity(FVC),forced expiratory volume in one second(FEV 1),FEV 1 predicted(FEV 1%)and peak expiratory flow(PEF)in high-dose group were higher than those in middle-dose group and low-dose group(P<0.05).After treatment,levels of interleukin-4(IL-4),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in sputum in high-dose group were lower than those in middle-dose and low-dose groups(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:There is significant effect of salbutamol sulfate combined with high-dose budesonide suspension for aerosol inhalation on pediatric bronchial asthma combined with MP infection,the symptoms of which get improved in high-dose group.