N-乙酰半胱氨酸联合酚妥拉明治疗支气管肺炎患儿的疗效分析

Analysis of therapeutic effect of inhaled N-acetylcysteine combined with phentolamine in the treatment of children with bronchopneumonia

目的研究N-乙酰半胱氨酸雾化吸入联合酚妥拉明对支气管肺炎患儿的疗效及对白三烯E4(LTE4)和可溶性白细胞介素-2受体(sIL-2R)水平的影响。方法选取120例支气管肺炎患者作为研究对象,按照随机分组原则均分为2组,每组60例,2组患者均采取N-乙酰半胱氨酸雾化吸入治疗,观察组患者在此基础上联合使用酚妥拉明,2组患者均治疗7 d。比较2组患者的肺炎症状积分、治疗效果、临床症状改善情况、免疫功能、LTE4、sIL-2R水平以及不良反应之间的差异。结果治疗2,4,6,7 d后,2组患儿的肺炎症状积分均明显下降,且观察组患儿的肺炎症状积分均小于对照组;观察组患者的临床症状(发热、咳嗽、啰音)消失时间和住院时间显著短于对照组(P<0.05);观察组患者的免疫球蛋白A(IgA)、免疫球蛋白M(IgM)和免疫球蛋白G(IgG)显著高于对照组;观察组患者的LTE4和sIL-2R水平显著低于对照组;2组患者的不良反应比较差异无统计学意义(P>0.05)。结论N-乙酰半胱氨酸雾化吸入联合酚妥拉明治疗支气管肺炎,通过对患者LTE4和sIL-2R水平的下调,患者的治疗效果显著,建议临床推广使用。

Objective To study the effect of N-acetylcysteine atomization combined with phentolamine on children with bronchopneumonia and the levels of leukotriene E4(LTE4)and soluble interleukin-2 receptor(sIL-2R).Methods 120 patients with bronchop-neumonia were taken as the study subjects.According to the principle of random grouping,the above patients were randomly divided into 2 groups,60 patients in each group.Both groups were treated with N-acetylcysteine atomization inhalation.On this basis,patients in the observation group were treated with phentolamine,and both groups were treated for 7 consecutive days.The difference of symptom score,therapeutic effect,clinical symptom improvement,immune function,LTE4,sIL-2R level and adverse reactions between the 2 groups were compared.Results After 2,4,6 and 7 d of treatment,the score of pneumonia symptoms in the 2 groups decreased significantly,and the score of pneumonia symptoms in the observation group was less than that in the control group;the time of clinical symptoms(fever,cough,rale)disappearance and hospitalization in the observation group was significantly lower than that in the control group(P<0.05);the immunoglobulin A(IgA),immunoglobulin M(IgM)and immunoglobulin G(IgG)in the observation group were significantly higher than those in the control group.The level of LTE4 and sIL-2R in the observation group was significantly lower than that in the control group,and there was no significant difference in adverse reactions between the 2 groups(P>0.05).Conclusion Nebulized inhalation of N-acetylcysteine combined with phentolamine showed significant therapeutic effects in patients with reduced LTE4 and sIL-2R levels,suggesting clinical application.