干扰素联合沙丁胺醇雾化配合氧疗在儿童支气管肺炎中的应用

Application of interferon combined with salbutamol atomization combined with oxygen therapy in children with bronchopneumonia

目的探讨干扰素联合沙丁胺醇雾化配合氧疗对儿童支气管肺炎的临床疗效。方法将90例支气管肺炎患儿随机分为A组45例和B组45例。A组用采用重组人干扰素α1b注射液(1次2~4μg·kg^(-1)用0.9%氯化钠注射液2 mL溶解)进行氧驱雾化(面罩吸氧,氧流量6 L·min^(-1))治疗10 min,每日2次,给药时间间隔超过6 h,持续治疗7 d。B组在A组基础上加用沙丁胺醇0.5 mg,加入0.9%氯化钠注射液2 mL中,进行氧驱雾化(面罩吸氧,氧流量6 L·min^(-1))治疗10 min,每日2次,给药时间间隔超过6 h,持续治疗7 d。比较2组免疫球蛋白E(IgE)和肺部X线片阴影恢复正常时间,心肌酶活性[乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)],C反应蛋白(CRP)水平及临床症状观察指标及药物不良反应发生率。结果治疗后,A组和B组患者临床症状咳嗽消失时间分别为(5.44±0.54)和(4.22±0.47)d,发热消失时间分别为(2.98±0.50)和(2.04±0.47)d,肺部啰音消失时间分别为(5.58±1.23)和(4.96±0.77)d,喘息消失时间分别为(4.98±0.69)和(4.04±0.67)d,IgE恢复正常时间分别为(6.77±0.90)和(6.16±0.86)d,肺部X线片阴影恢复正常时间分别为(7.13±0.66)和(6.00±0.60)d,CK分别为(151.08±17.36)和(118.37±18.53)U·L^(-1),肌酸激酶同工酶(CK-MB)分别为(19.88±4.95)和(17.69±3.70)U·L^(-1),LDH分别为(205.77±20.38)和(171.14±15.44)U·L^(-1),CRP水平分别为(16.17±1.49)和(11.77±1.78)mg·L^(-1),差异均有统计学意义(均P<0.05)。结论干扰素联合沙丁胺醇雾化配合氧疗对儿童支气管肺炎疗效更为优越,且安全性良好。

Objective To explore the clinical effect of interferon combined with salbutamol atomization and oxygen therapy on children with bronchopneumonia.Methods Ninety children with bronchopneumonia were randomly divided into 45 cases in group A and 45 cases in group B.Group A was treated with recombinant human interferonα1b injection(2-4μg·kg^(-1) dissolved in 0.9%NaCl injection 2 mL once)for 10 min by oxygen flooding atomization(oxygen inhalation by mask,oxygen flow 6 L·min^(-1)),twice a day,with an interval of more than 6 h,lasting for 7 d.Group B was additionally treated with salbutamol 0.5 mg added into 0.9%NaCl injection 2 mL for oxygen flooding atomization(oxygen inhalation by mask,oxygen flow rate of 6 L·min^(-1))for 10 min,twice a day,with an interval of more than 6 h,lasting for 7 d.The recovery time of immunoglobulin E(IgE)and pulmonary X-ray shadow,the activity of myocardial enzymes[lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)],the levels of C-reactive protein(CRP),the observation indexes of clinical symptoms,and the incidence of adverse drug reactions were compared between the two groups.Results After treatment,the disappearance time of cough in group A and group B were(5.44±0.54)and(4.22±0.47)d;the disappearance time of fever were(2.98±0.50)and(2.04±0.47)d;the disappearance time of lung rale were(5.58±1.23)and(4.96±0.77)d;the disappearance time of wheezing were(4.98±0.69)and(4.04±0.67)d;the recovery time of IgE were(6.77±0.90)and(6.16±0.86)d;the recovery time of pulmonary X-ray shadow were(7.13±0.66)and(6.00±0.60)d;CK were(151.08±17.36)and(118.37±18.53)U·L^(-1);CK-MB were(19.88±4.95)and(17.69±3.70)U·L^(-1);LDH were(205.77±20.38)and(171.14±15.44)U·L^(-1),and CRP were(16.17±1.49)and(11.77±1.78)mg·L^(-1);the differences were all statistically significant(all P<0.05).Conclusion Interferon combined with salbutamol atomization combined with oxygen therapy is more effective and safe in the treatment of bronchopneumonia in children.