上呼吸道感染患儿治疗前后血清淀粉样蛋白A等的表达差异与临床意义

目的探讨头孢克肟结合盐酸氨溴索雾化吸入对上呼吸道感染发热患儿治疗效果及对血清淀粉样蛋白A(SAA)等水平的影响。方法选取2018年1月至2020年12月秦皇岛市第一医院收治的252例上呼吸道感染发热患儿作为研究对象,应用随机数字表将其随机分为对照组和研究组,各126例。两组患儿均应用头孢克肟颗粒进行治疗,研究组患儿在此基础上联合应用盐酸氨溴索雾化吸入治疗,比较两组患儿的治疗效果、症状改善时间、不良反应发生情况及治疗前后血清常规炎症因子、白细胞计数、中性粒细胞百分比和SAA等水平变化情况。结果研究组治疗总有效率为93.65%,对照组为83.33%,两组比较差异有统计学意义(P<0.05);治疗后两组患儿的体温较治疗前均显著降低,且研究组患儿的体温显著低于对照组(P<0.05);研究组患儿退热时间、咳嗽及全身症状消失时间均显著低于对照组(P<0.05)。两组患儿药物不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后两组患儿血清SAA、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)和白细胞计数、中性粒细胞比值较治疗前均显著降低,且研究组患儿上述血清炎症因子水平和白细胞计数、中性粒细胞比值均显著低于对照组(P<0.05)。结论头孢克肟联合盐酸氨溴索雾化吸入治疗上呼吸道感染发热患儿治疗效果显著,用药后能快速退热,并有效缓解患儿的咳嗽症状和全身症状,其有利于降低血清常规炎症因子水平,改善血常规,从而有效抑制全身炎症反应。

Objective To investigate the therapeutic effect of Cefixime combined with Ambroxol Hydrochloride atomization inhalation on children with fever caused by upper respiratory tract infection and on he level of serum amyloid A(SAA).Methods 252 children with upper respiratory tract infection and fever treated in Qinhuangdao first hospital from January 2018 to December 2020 were selected as the research objects.They were randomly divided into control group and study group with 126 cases in each group.The children in the two groups were treated with Cefixime granules.On this basis,the children in the study group were treated with Ambroxol Hydrochloride atomization inhalation.The treatment effect,symptom improvement time,adverse reactions and the changes of serum routine inflammatory factors,leukocyte count,neutrophil percentage and SAA before and after treatment were compared between the two groups.Results The total effective rate was 93.65%in the study group and 83.33%in the control group.There was significant difference between the two groups(P<0.05);After treatment,the body temperature of the two groups was significantly lower than that before treatment,and the body temperature of the study group was significantly lower than that of the control group(P<0.05);The fever relieving time,cough and disappearance time of systemic symptoms in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).After treatment,serum SAA,tumor necrosis factora(TNF-α),the levels of interleukin-6(IL-6),C-reactive protein(CRP),leukocyte count and neutrophil ratio in both groups were significantly lower than those before treatment.The levels of serum inflammatory factors,leukocyte count and neutrophil ratio in the study group were significantly lower than those in the control group(P<0.05).Conclusion Cefixime combined with Ambroxol Hydrochloride atomization inhalation has a significant therapeutic effect in the treatment of children with fever caused by upper respiratory tract infection.After medication,it can quickly reduce fever and effectively alleviate children's cough symptoms and systemic symptoms.It is conducive to reduce the level of routine inflammatory factors in serum,improve blood routine,and effectively inhibit systemic inflammatory response.