阿奇霉素序贯疗法联合布地奈德雾化吸入对支原体肺炎患儿肺功能及炎性反应的影响研究

The Effect of Azithromycin Sequential Therapy Combined with Budesonide Aerosol Inhalation on Pulmonary Function and Inflammatory Response in Children with Mycoplasma Pneumonia

目的 研究支原体肺炎(MPP)患儿应用阿奇霉素序贯疗法联合布地奈德雾化吸入治疗的疗效及对肺功能、炎性反应的影响。方法 选取2021年1月至2022年1月收治的80例MPP患儿,按随机数字表法分组,入组者行止咳、祛痰、平喘及退热等对症治疗,同时维持酸碱、水电解质平衡,在此基础上对照组(40例)加用阿奇霉素序贯疗法,治疗组(40例)在对照组的基础上加用布地奈德雾化吸入,对比两组治疗效果、症状消失时间、肺功能、炎性因子、免疫功能、氧化应激。结果 治疗组92.50%(37/40)总有效率较之对照组70.00%(28/40)更高(P <0.05);治疗组肺部啰音消失时间、咳嗽消失时间、体温恢复时间、胸片阴影消失时间较之对照组更短(P <0.05);治疗组治疗后FEV1、FVC、PEF、FEV1/FVC水平较之对照组更高(P <0.05);治疗组治疗后IL-2、IL-6、INF-γ、TNF-α、CRP水平较之对照组更低(P <0.05);治疗组治疗后CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平较之对照组更高(P <0.05);治疗组治疗后IgG、IgM、CD_(8)^(+)水平较之对照组更低(P <0.05);治疗组治疗后MDA水平较之对照组更低,GSH-Px、SOD水平较之对照组更高(P <0.05)。结论 MPP患儿应用阿奇霉素序贯疗法联合布地奈德雾化吸入治疗,有利于肺功能改善,缩短患儿症状消失时间,可促进炎性反应减轻,并改善免疫功能。

Objective To study the effect of sequential azithromycin therapy combined with budesonide aerosol inhalation on pulmonary function and inflammatory response in children with mycoplasma pneumonia(MPP).Methods Eighty children with MPP admitted from January 2021 to January 2022 were divided into groups according to the random number table.The patients in the group received symptomatic treatment such as cough relieving,expectorant,asthma relieving and fever relieving,while maintaining the balance of acid-base,water and electrolyte.On this basis,the control group(40 cases) was added with azithromycin sequential therapy,and the treatment group(40 cases) was added with budesonide aerosol inhalation on the basis of the control group.The therapeutic effect,time of symptom disappearance,pulmonary function Inflammatory factors,immune function,oxidative stress.Results The total effective rate of 92.50%(37/40) in the treatment group was higher than that of 70.00%(28/40)in the control group(P<0.05);The disappearance time of lung rales,cough,body temperature and chest shadow in the treatment group were shorter than those in the control group(P<0.05);After treatment,the levels of FEV1,FVC,PEF,FEV1/FVC in the treatment group were higher than those in the control group(P<0.05);IL-2,IL-6 and INF in the treatment group after treatment-γ,TNF-α,CRP level was lower than that of the control group(P<0.05);The levels of CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) in the treatment group were higher than those in the control group(P<0.05);The levels of IgG,IgM and CD_(8)^(+) in the treatment group were lower than those in the control group(P<0.05);After treatment,the MDA level in the treatment group was lower than that in the control group,and the GSH-Px and SOD levels were higher than those in the control group(P<0.05).Conclusion The sequential therapy of azithromycin combined with budesonide aerosol inhalation in children with MPP is beneficial to the improvement of pulmonary function,shortening the time of symptom disappearance,promoting the reduction of inflammatory reaction and improving immune function.