布地奈德联合β受体激动剂对儿童喘息性支气管炎气道重塑的影响

Effect of budesonide combined with beta-receptor agonist on airway remodeling in children with asthmatic bronchitis

目的探索布地奈德联合特布他林对儿童喘息性支气管炎患者肺功能改善作用及对血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制物-1(TIMP-1)表达的影响。方法选取2018年7月至2020年7月收治于西安国际医学中心医院的162例儿童喘息性支气管炎患者作为研究对象,按照随机数表法将其分为对照组和观察组,每组81例。两组患者均给予抗感染、吸氧、止咳等常规治疗,对照组联合应用布地奈德雾化吸入治疗,观察组在对照组治疗的基础上加用特布他林雾化吸入治疗,疗程为7~15 d。治疗后比较两组患者的治疗效果,治疗前后的肺功能改善情况及血清MMP-9、TIMP-1表达水平,同时比较两组患者治疗过程中不良反应发生情况。结果治疗结束后,观察组患者的治疗有效率为93.83%,明显高于对照组的80.25%,差异有统计学意义(P<0.05);治疗前两组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气中段流量(MMEF)比较差异均无统计学意义(P>0.05),治疗结束后,两组患者FEV1、FVC、MMEF均明显增高,且观察组的上述各项指标明显高于对照组,差异均有统计学意义(P<0.05);治疗前,两组患者的血清MMP-9、TIMP-1比较差异均无统计学意义(P>0.05),治疗结束后,两组患者的血清MMP-9、TIMP-1水平明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组和对组组患者不良反应发生分别为1.23%、3.70%,差异无统计学意义(P>0.05)。结论布地奈德联合特布他林治疗儿童喘息性支气管炎可有效改善患者的肺功能,下调血清MMP-9、TIMP-1表达水平,且不增加不良反应,临床治疗效果确切,值得推广应用。

Objective To explore the effect of budesonide combined with terbutaline on improvement pulmonary function and the expression of matrix metalloproteinase-9(MMP-9)and matrix metalloproteinase inhibitor-1(TIMP-1)in children with asthmatic bronchitis.Methods A total of 162 children with asthmatic bronchitis admitted to Xi’an International Medical Center Hospital from July 2018 to July 2020 were selected as the study subjects.They were divided into a control group and an observation group according to random number table method,with 81 patients in each group.Both groups were given routine treatment such as anti-infection,oxygen inhalation and cough relief.The control group was treated with budesonide aerosol inhalation.The observation group was treated with terbutaline aerosol inhalation on the basis of the control group,with 7 to 15 days as course of treatment.The therapeutic effects between the two groups were compared after treatment.The improvement of pulmonary function and the expression of serum MMP-9 and TIMP-1 were measured and compared before and after treatment.The adverse reactions during the treatment were recorded.Results After treatment,the effective rate of the control group was 93.83%,which was significantly higher than 80.25%of the observation group(P<0.05).There were no significant differences in forced expiratory volume(FEV1),forced vital capacity(FVC),and maximum expiratory flow(MMEF)between the two groups before treatment(P>0.05).After treatment,the FEV1,FVC,and MMEF were significantly increased in the two groups,and the above indexes in the observation group were significantly higher than those in the control group(P<0.05).Before treatment,there was no significant difference in serum MMP-9 and TIMP-1 between the two groups(P>0.05).After treatment,the levels of serum MMP-9 and TIMP-1 between the two groups were significantly reduced,and the levels in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(1.23%vs 3.70%,P>0.05).Conclusion Budesonide combined with terbutaline in the treatment of asthmatic bronchitis in children can effectively improve the pulmonary function of patients,down-regulate the expression of serum MMP-9 and TIMP-1,and does not increase the incidence of adverse reactions.It has significant therapeutic effect and is worthy of wide clinical application.