吸入乙酰半胱氨酸佐治儿童迁延性细菌性支气管炎的疗效研究

Effect of inhalation of acetylcysteine combined with amoxicillin clavulinic acid in treatment of protracted bacterial bronchitis in children and its effect on immune function

目的探讨吸入乙酰半胱氨酸溶液(N-ace-tylcysteine,NAC)联合阿莫西林克拉维酸钾对儿童迁延性细菌性支气管炎(protracted bacterial bronchitis,PBB)的治疗效果及对患儿细胞免疫功能的影响。方法选取2015年1月至2018年12月我院儿科诊治的128例PBB患儿为研究对象,随机分为对照组63例,观察组65例,对照组给予口服阿莫西林克拉维酸钾及氨溴特罗口服溶液治疗,观察组在对照组的基础上联合吸入用乙酰半胱氨酸溶液雾化,对两组患儿经过上述治疗后的临床疗效、细胞免疫功能及不良反应变化进行比较。结果经治疗后,观察组总有效率为96.92%高于对照组的87.30%,差异存在统计学意义(P<0.05);与对照组相比较,观察组咳嗽、咳痰症状及肺部啰音体征消失时间明显缩短,差异存在统计学意义(P<0.05);经治疗后观察组血清CD3^+、CD4^+水平及CD4^+/CD8^+比例较对照组高,差异存在统计学意义(P<0.05);两组患儿不良反应的发生率相比较,差异无统计学意义(P>0.05)。结论阿莫西林克拉维酸制剂辅以NAC可有效改善PBB患儿的免疫状态,提高临床疗效,且安全性较好,具有较好的应用前景。

Objective To analyze the curative effect of N-ace-tylcystine(NAC)combined with amoxicillin and clavulanate potassium in treatment of childhood protracted bacterial bronchitis(PBB)and the influence on cellular immunity function.Methods From January 2015 to December 2018,128 children with PBB treated in our hospital were randomly divided into the control group(63 cases)and the observation group(65 cases).The control group was treated with amoxicillin clavulanate potassium and ambroxol hydrochloride and clenbuterol hydrochloride oral solution.The observation group was treated with acetylcysteine solution for inhalation on the basis of the control group.The therapeutic effect and cellular immunity function after treatment in the two groups were compared.Results After treatment,the total effective rate was 96.92%in the observation group,which was higher than that in the control group(87.30%,P<0.05).The disappearance time of cough,sputum and lung rales in the observation group was significantly lower than that in the control group(P<0.05).The levels of CD3^+,CD4^+ and CD4^+/CD8^+ in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of amoxicillin and clavulanate potassium combined with NAC in treatment of childhood PBB is significant,which can effectively improve immune function and clinical symptoms and have a good application prospect.