异丙托溴铵气雾剂联合吸入用布地奈德混悬液对BA患儿肺功能及复发率的影响

Effects of Ipratropium Bromide Aerosol combined with Budesonide Suspension on pulmonary Function and Recurrence Rate in Children with BA

目的探讨异丙托溴铵气雾剂联合吸入用布地奈德混悬液(商品名:普米克令舒)对支气管哮喘(BA)患儿肺功能及复发率的影响。方法前瞻性选取卢氏县第二人民医院2019年1月至2021年6月BA患儿96例,根据就诊时间编号,应用电脑随机数字表随机分为研究组(N=48)、对照组(N=48)。对照组应用普米克令舒治疗,研究组在对照组基础上加用异丙托溴铵气雾剂治疗,对比两组临床疗效、临床症状改善情况、肺功能[呼气峰流量(PEF)、第1秒最大呼气量(FEV1)、用力肺活量(FVC)]、血清因子水平[C反应蛋白(CRP)、白细胞介素-4(IL-4)、和肿瘤坏死因子-α(TNF-α)]及复发率。结果研究组治疗有效率95.74%显著高于对照组81.25%,差异统计学意义(P<0.05);研究组喘息缓解时间、咳嗽消失时间、肺哮鸣音消失时间、肺湿啰音消失时间显著短于对照组,差异统计学意义(P<0.05);治疗1个疗程后,两组PEF、FVC、FEV1水平均升高,且研究组各指标水平改善程度大于对照组,差异统计学意义(P<0.05);治疗1个疗程后,两组CRP、IL-4、TNF-α水平均降低,且研究组各指标水平变化幅度大于对照组,差异统计学意义(P<0.05);治疗后6个月,研究组复发率38.30%显著低于对照组60.42%,差异统计学意义(P<0.05)。结论异丙托溴铵气雾剂联合普米克令舒治疗BA能改善患儿临床症状,修复肺损伤,降低复发率,值得临床应用。

Objective To investigate the effect of ipratropium bromide aerosol combined with budesonide suspension(trade name:Pulmicort Respules)on pulmonary function and recurrence rate in children with bronchial asthma(BA).Methods A total of 96 children with BA in our hospital from January 2019 to June 2021 were prospectively selected.According to the treatment time number,they were randomly divided into study group(N=48)and control group(N=48)by computer random number table.The control group was treated with Pulmicort Respules,while the study group was treated with ipratropium bromide aerosol on the basis of the control group.The clinical efficacy,clinical symptom improvement,lung function[peak expiratory flow(PEF),maximum expiratory volume in the first second(FEV1),forced vital capacity(FVC)],serum factor levels[C-reactive protein(CRP),interleukin-4(IL-4),and tumor necrosis factorα(TNF-α)]and recurrence rate were compared between the two groups Results The total effective rate of the study group was 95.74%,which was significantly higher than that of the control group(81.25%)(P<0.05);The relief time of wheezing,disappearance time of cough,disappearance time of lung wheezing and disappearance time of lung moist rale in the study group were significantly shorter than those in the control group(P<0.05);After one course of treatment,the levels of PEF,FVC and FEV1 in the two groups increased,and the improvement of each index level in the study group was higher than that in the control group(P<0.05);After one course of treatment,the levels of CRP,IL-4,TNF-αin the two groups decreased,the level of each index in the study group was significantly lower than that in the control group(P<0.05);Six months after treatment,the recurrence rate in the study group was 38.30%,which was significantly lower than that in the control group(60.42%),The difference was statistically significant(P<0.05).Conclusion Ipratropium bromide aerosol combined with Pulmicort Respules in the treatment of BA can improve the clinical symptoms,repair lung injury and reduce the recurrence rate,which is worthy of clinical application.