纤支镜下盐酸氨溴索灌洗联合阿奇霉素静滴对肺炎支原体肺炎患儿外周血及气道炎症因子水平和T淋巴细胞亚群水平的影响

Effects of ambroxol hydrochloride lavage by fiberbronchoscope combined with azithromycin intravenous drip on the levels of inflammatory factors and T lymphocyte subpopulation levels in peripheral blood and airway of children with mycoplasma pneumoniae pneumonia

目的探讨纤支镜下盐酸氨溴索灌洗联合阿奇霉素静滴对肺炎支原体肺炎患儿外周血及气道炎症因子水平和T淋巴细胞亚群水平的影响。方法徐州医科大学附属徐州儿童医院2019年2月至2019年12月收治的86例肺炎支原体肺炎患儿随机分为常规组和观察组,每组43例。常规组予以基础治疗+阿奇霉素静滴,观察组予以基础治疗+阿奇霉素静滴+纤支镜下盐酸氨溴索灌洗。对比两组治疗效果,治疗前后外周血及气道炎症因子和T淋巴细胞亚群水平变化及药物不良反应。结果两组治疗效果差异有统计学意义,观察组总有效率高于常规组(100.00%比86.05%,P<0.05);治疗后观察组外周血肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-6、IL-8水平分别为(0.90±0.21)pg/mL、(11.09±2.07)pg/mL和(7.80±1.60)pg/mL,常规组分别为(1.62±0.34)pg/mL、(20.15±3.08)pg/mL和(14.05±2.15)pg/mL,均较治疗前降低,且治疗后观察组低于常规组,差异均有统计学意义(P值均<0.05);治疗后观察组诱导痰中性粒细胞、淋巴细胞、嗜酸性粒细胞比例分别为(27.20±3.85)%、(0.85±0.15)%和(1.50±0.27)%,常规组分别为(32.02±4.07)%、(2.20±0.32)%和(3.05±0.75)%,均较治疗前降低,且治疗后观察组均低于常规组,差异均有统计学意义(P值均<0.05);治疗后观察组外周血CD3+、CD4+、CD4+/CD8+分别为(79.80±7.05)%、(52.40±5.45)%和(1.90±0.25)%,常规组分别为(71.58±6.95)%、(46.89±5.12)%和(1.52±0.22)%,均较治疗前升高,且治疗后观察组均高于常规组,差异均有统计学意义(P值均<0.05);治疗后观察组外周血CD8+比例为(27.51±3.06)%,常规组为(30.80±3.19)%,两组均较治疗前下降,且治疗后观察组低于常规组,差异均有统计学意义(P<0.05);两组均未观察到药物不良反应。结论纤支镜下盐酸氨溴索灌洗联合阿奇霉素静滴可增强肺炎支原体肺炎患儿的治疗效果,可减轻外周血及气道炎症,改善T淋巴细胞亚群水平,安全有效。

Objective To explore the effect of ambroxol hydrochloride lavage by fiberbronchoscope combined with azithromycin intravenous drip on the levels of inflammatory factors and T lymphocyte subpopulation levels in peripheral blood and airway of children with Mycoplasma pneumoniae pneumonia.Methods A total of 86 children with Mycoplasma pneumoniae pneumonia in Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from February 2019 to December 2019 were randomly divided into routine group and observation group with 43 patients in each group.Routine group were treated with basic therapy+azithromycin intravenous drip,and observation group were treated with basic therapy+azithromycin intravenous drip+ambroxol hydrochloride lavage by fiberbronchoscope.The changes of inflammatory factors and T lymphocyte subpopulation levels in peripheral blood and airway before and after treatment were,adverse drug reactions were compared with the two groups.Result There was a significant differences in the efficacy distribution between the two groups,and the total effective rate in the observation group was higher than that in the routine group(100.00%vs 86.05%,P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-8 in peripheral blood of the observation group were(0.90±0.21),(11.09±2.07)and(7.80±1.60)pg/mL,respectively,and those in the conventional group were(1.62±0.34),(20.15±3.08)and(14.05±2.15)pg/mL respectively,which were lower than those before treatment in the observation group,and the differences were statistically significant(all P values<0.05).After treatment,the induced sputum neutrophils,lymphocytes,eosinophils of the observation group were(27.20±3.85)%,(0.85±0.15)%and(1.50±0.27)%,respectively,those were(32.02±4.07)%,(2.20±0.32)%and(3.05±0.75)%,respectively in the routine group,which were higher than those before treatment,and the observation group was higher than the conventional group after treatment,the differences were statistically significant(all P values<0.05).After treatment,CD3+,CD4+,CD4+/CD8+in the observation group were(79.80±7.05)%,(52.40±5.45)%and(1.90±0.25)%respectively,those were(71.58±6.95)%,(46.89±5.12)%and(1.52±0.22)%respectively in the routine group,which was lower than that before treatment,and the difference was statistically significant(all P values<0.05).After treatment,CD8+in the observation group was(27.51±3.06)%,this was(30.80±3.19)%in the routine group,and those decreased compared with those before treatment,and the levels of CD8+in the observation group after treatment was lower than that in the routine group(P<0.05).No adverse drug reactions were observed in both groups.Conclusion Ambroxol hydrochloride lavage by fiberbronchoscope combined with azithromycin intravenous drip can not only enhance the curative effect of children with Mycoplasma pneumoniae pneumonia,but also reduce the inflammation of peripheral blood and airway,improve the T lymphocyte subpopulation levels,which is safe and effective.