儿童肺炎支原体肺炎ICS治疗干预后肺功能改变研究

Pulmonary Function Changes in Children with Mycoplasma Pneumoniae Pneumonia after ICS Treatment Intervention

目的探讨儿童肺炎支原体肺炎在肺功能监测下行ICS(吸入性糖皮质激素)治疗干预后患儿肺功能的改变情况。方法对该院2017年6月—2019年6月诊治的肺炎支原体肺炎的儿童100例进行盲法随机分组对比研究,其中对照组50例患儿在阿奇霉素治疗下未干预定期监测肺功能,而ICS治疗组50例在阿奇霉素治疗后进行肺功能监测,肺功能有异常时予ICS吸入干预,对比两组患儿治疗后恢复期、3、6个月的肺功能改善情况。结果 ICS治疗组的近期治疗有效率为96.0%,而对照组为94.0%,两组比较差异无统计学意义(χ2=1.141,P>0.05);疗程结束后,随着时间延长,ICS治疗组肺功能指标PEF、FEV1、FVC均呈逐渐升高趋势,但在恢复期,各项肺功能指标与对照组比较差异无统计学意义(P>0.05),而在治疗后3个月和6个月的PEF、FEV1、FVC分别为[(3.32±0.54)L/S、(1.42±0.25)L、(1.53±0.12)L]和[(3.98±0.51)L/S、(1.95±0.54)L、(1.65±0.21)L],均明显高于对照组,差异有统计学意义(t=3.690、4.550、3.020、3.656、4.210、3.280,P<0.05)。结论肺炎支原体肺炎患儿在肺功能仪监测下,调整ICS的吸入干预治疗,可有效改善患儿的肺功能,促进疾病的康复。

Objective To investigate the changes of lung function in children with Mycoplasma pneumoniae pneumonia after lung function monitoring after ICS(inhaled glucocorticoid) treatment intervention.Methods A blind randomized comparison study was performed on 100 children with Mycoplasma pneumoniae pneumonia diagnosed and treated in the hospital from June 2017 to June 2019.Among them,50 children in the control group were not regularly monitored for pulmonary function under azithromycin treatment,and ICS of 50 patients in the treatment group were monitored for pulmonary function after azithromycin treatment.ICS inhalation intervention was performed when there was abnormal lung function,and the pulmonary function improvement in the recovery period,3,and 6 months after treatment was compared between the two groups.Results The short-term effective rate of the ICS treatment group was 96%,while the control group was 94.0%.There was no significant difference between the two groups(χ2=1.141,P>0.05).After the end of the treatment course,with the extension of time,ICS Pulmonary function indicators PEF,FEV1,and FVC in the treatment group all gradually increased,but during the recovery period,the pulmonary function indicators were not significantly different from those in the control group P>0.05).PEF,FEV1,and FVC at 6 months were [(3.32±0.54)L,(1.42±0.25)L,(1.53±0.12)L] and [(3.98±0.51)L/S,(1.95±0.54)L,(1.65±0.21)L],which were significantly higher than those in the control group.The difference was statistically significant(t=3.690,4.550,3.020,3.656,4.210,3.280,P<0.05).Conclusion Children with Mycoplasma pneumoniae pneumonia under the monitoring of the pulmonary function instrument,adjusting the inhalation intervention of ICS can effectively improve the lung function of children and promote the rehabilitation of the disease.