糖皮质激素联合支气管扩张剂治疗哮喘合并小气道损伤患儿的临床效果

Effects of glucocorticoid combined with bronchodilator on children with asthma complicated with small airway injury

目的探讨糖皮质激素联合支气管扩张剂对哮喘合并小气道损伤患儿的临床效果。方法抽取2016年1月至2019年1月开封市儿童医院收治的哮喘患儿108例,采用随机数字表法分为观察组与对照组,每组54例,两组患儿均予以布地奈德治疗,观察组患儿在此基础上采联合应用丙卡特罗治疗。比较两组患儿治疗2周后的临床疗效,治疗前、治疗2周后肺功能相关指标[用力肺活量(FVC)、一秒用力呼气容积(FEV1)、呼气峰值流速(PEF)]、小气道功能相关指标[用力呼吸75%肺活量(FEF75)、用力呼吸50%肺活量(FEF50)、最大呼吸中期流量(MMEF75/25)]、血清气道炎症相关指标[白细胞介素-6(IL-6、白细胞介素-35(OL-35))、嗜酸性粒细胞(EOS)]水平变化。结果治疗2周后,观察组总有效率高于对照组(P<0.05);两组患儿FVC、FEV1、PEF均较治疗前升高,且观察组高于对照组(P均<0.05);两组患儿FEF75、FEF50、MMEF75/25较治疗前升高,且观察组高于对照组(P均<0.05);两组患儿血清IL-35均较治疗前升高,且观察组高于对照组,IL-6、EOS均较治疗前降低,且观察组低于对照组(P均<0.05)。结论糖皮质激素联合支气管扩张剂治疗哮喘患儿疗效确切,可显著改善患儿小气道功能,缓解气道炎症。

Objective To explore the effects of glucocorticoid combined with bronchodilator on children patients with asthma complicated with small airway injury.Methods A total of 108 children patients with asthma in Kaifeng Children’s Hospital from January 2016 to January 2019 were included in the study.The patients were divided into observation group and control group by random number table method,with 54 cases in each group.The two groups were treated with budesonide,and the children in observation group were combined with procaterol on this basis.The clinical efficacy after 2 weeks of treatment,lung function-related indicators[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF)],small airway function-related indicators[75%forced expiratoryvital capacity(FEF75),50%forcedexpiratory vital capacity(FEF50),maximum midexpiratory flow(MMEF75/25)]and serum airway inflammation-related indicators[interleukin-6(IL-6),interleukin-35(IL-35),eosinophil(EOS)]before treatment and after 2 weeks of treatment were compared between the two groups.Results After 2 weeks of treatment,the total effective rate in observation group was higher than that in control group(P<0.05).The FVC,FEV1 and PEF in the two groups were higher than those before treatment,and the indicators in observation group were higher than those in control group(all P<0.05).The FEF75,FEF50 and MMEF75/25 in the two groups were significantly higher than those before treatment,and the indicators in observation group were higher than those in control group(P all<0.05).The serum IL-35 level in the two groups was higher than that before treatment,and the level in observation group was higher than that in control group,and the levels of IL-6 and EOS were lower than those before treatment,and the levels in observation group were lower than those in control group(all P<0.05).Conclusions Glucocorticoid combined with bronchodilator has exact efficacy in the treatment of children patients with asthma,and it can significantly improve the small airway function and relieve airway inflammation.