糖皮质激素治疗对毛细支气管炎后反复喘息患儿生长发育的影响

Effect of Glucocorticoid Therapy on Growth and Development of Children with Recurrent Wheezing after Bronchiolitis

目的:探讨糖皮质激素治疗对毛细支气管炎后反复喘息患儿生长发育的影响。方法:选取孝感市妇幼保健院2019年1月-2021年1月收治的110例毛细支气管炎患儿为研究对象,按随机数表法分为两组,各55例。毛细支气管炎治愈后,对照组未给予干预,观察组采用糖皮质激素治疗。比较两组生长发育、临床症状改善情况及远期疗效。结果:两组入组时、随访1年后生长发育指标比较,差异均无统计学意义(P>0.05);但两组随访1年后体质量、身高、超声波传导速度(SOS)和胰岛素样生长因子-Ⅰ(IGF-Ⅰ)高于入组时,差异均有统计学意义(P<0.05)。两组入组时和随访1年后P^(3+)、Ca^(2+)、骨钙素(BGP)水平组间组内比较,差异均无统计学意义(P>0.05)。随访1年后,两组症状评分均低于入组时,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗结束随访1年发现,观察组喘息发作率低于对照组,喘息发作次数少于对照组,差异均有统计学意义(P<0.05)。结论:应用糖皮质激素治疗毛细支气管炎后反复喘息患儿,可有效改善临床症状,提高远期疗效,且对生长发育无影响,值得临床推广应用。

Objective:To investigate the effect of Glucocorticoid therapy on the growth and development of children with recurrent wheezing after bronchiolitis.Method:A total of 110 children with bronchiolitis who treated in Maternal and Child Health Hospital of Xiaogan from January 2019 to January 2021 were selected as the research objects.They were divided into two groups by random number table method,55 cases in each group.After bronchiolitis was cured,the control group was not intervened,and the observation group was treated with Glucocorticoids.The growth and development,clinical symptom improvement and long-term curative effect of two groups were compared.Result:There were no significant differences in growth and development indicators between two groups at the time of enrollment and after 1 year of follow-up(P>0.05);however,the body mass,height,speed of sound(SOS)and insulin-like growth factor-Ⅰ(IGF-Ⅰ)of two groups after 1 year of follow-up were significantly higher than those of the time of enrollment,the differences were statistically significant(P<0.05).There were no significant differences in P^(3+),Ca^(2+),and bone gla protein(BGP)levels between two groups at the time of enrollment and one year after follow-up(P>0.05).After 1 year of follow-up,the symptom scores of two groups were lower than those of the time of enrollment,and the scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).During one-year follow-up,the asthmatic attack rate and the number of asthmatic attacks in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The use of Glucocorticoid in the treatment of children with recurrent wheezing after bronchiolitis can effectively improve clinical symptoms,improve long-term efficacy,and has no impact on growth and development,which is worthy of clinical application.