布地奈德混悬液雾化吸入对肺炎支原体肺炎致慢性咳嗽的预防研究

Prevention effects of budesonide inhalation suspension on mycoplasmal pneumonia induced chronic cough

目的探讨布地奈德混悬液雾化吸入对肺炎支原体肺炎致慢性咳嗽的预防作用。方法选取2017年3月~2019年3月在我科确诊为肺炎支原体肺炎,出院前存在小气道阻塞性病变的3523例患儿作为研究对象。2289例规则布地奈德混悬液雾化吸入1个月的患儿设定为雾化组(A组),1234例未规则雾化的患儿设定为对照组(B组),对比两组慢性咳嗽发生率;并探讨A组发生慢性咳嗽的高危因素。结果A组慢性咳嗽患儿753例(32.9%),B组慢性咳嗽患儿652例(52.8%),两者差异存在统计学意义(P<0.05);通过单因素及多因素Logistic回归分析,结果提示特应性体质(OR=2.00)及呼吸道病毒感染(OR=2.20)为A组发生慢性咳嗽的高危因素。结论布地奈德混悬液雾化吸入可降低存在小气道功能障碍的肺炎支原体肺炎患儿慢性咳嗽发生率。但若患儿存在特应性体质或混合存在呼吸道病毒感染,1个月雾化治疗后慢性咳嗽发生风险仍较高。

Objective To investigate prevention effects of budesonide inhalation suspension on mycoplasmal pneumonia induced chronic cough.Methods From March 2017 to March 2019,3,523 children diagnosed as mycoplasmal pneumonia were admitted in our department and still had small-airway obstruction after discharge were selected as subjects.In the inhalation group(group A),2,289 children who received regular budesonide inhalation for 1 month were enrolled.In the control group(group B),1,234 cases underwent irregular treatment of budesonide inhalation were included.Incidence rates of chronic cough were compared between the two groups.High-risk factors of chronic cough in group A were discussed.Results There were 753 children(32.9%)with the presence of chronic cough in group A and 652(52.8%)in group B,with statistically significant differences between the two groups(P<0.05).Single-factor and multifactor Logistic regression showed that family-specific constitution[odds ratio(OR)=2.00]and respiratory virus infection(OR=2.20)were two high-risk factors of chronic cough in group A.Conclusion Budesonide inhalation suspension can reduce the incidence rate of chronic cough induced by mycoplasmal pneumonia in child patients with small-airway obstruction.However,a risk for the onset of chronic cough is still high despite a 1-month regular inhalation in condition of family-specific constitution and respiratory virus infection in the patients.