布地奈德雾化吸入剂治疗肺炎支原体肺炎患儿的临床研究

Clinical trial of budesonide atomization inhalation in the treatment of children with mycoplasma pneumoniae pneumonia

目的观察布地奈德雾化吸入剂治疗肺炎支原体肺炎(MPP)患儿的临床疗效及安全性。方法将重症MPP患儿随机分为对照组和试验组。对照组患儿采用退热、止咳、祛痰、吸氧和支气管扩张等基础治疗以及静脉滴注10 mg·kg^(-1)阿奇霉素,qd,连续5 d后改为口服5 mg·kg^(-1)阿奇霉素片,qd。试验组患儿在对照组治疗的基础上,联合布地奈德(每次2 mL,bid)雾化吸入辅助治疗。2组患儿均连续治疗2周。比较2组患儿的临床疗效,血清炎性因子水平、血清免疫球蛋白指标水平、发热减退时长、咳嗽消失时间,观察患儿药物不良反应发生情况。结果最终试验组和对照组各入组30例,试验过程中无脱落病例。治疗后,对照组和试验组的总有效率分别为73.33%和93.33%,差异有统计学意义(P<0.05)。治疗后,对照组与试验组的血清中白细胞介素-2(IL-2)水平分别为(262.11±40.26)和(172.51±27.18)ng·L^(-1);干扰素-α(INF-α)水平分别为(7.80±2.15)和(4.31±0.87)ng·L^(-1);免疫球蛋白A(IgA)水平分别为(0.70±0.35)和(0.53±0.18)g·L^(-1);IgM水平分别为(1.32±0.27)和(0.96±0.19)g·L^(-1);发热减退时长分别为(5.22±1.24)和(3.62±1.09)d;咳嗽消失时间分别为(7.51±1.35)和(5.90±1.24)d。试验组的上述指标与对照组比较,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应总发生率分别为13.33%(4例/30例)和10.00%(3例/30例),差异无统计学意义(P>0.05)。结论布地奈德雾化吸入辅助治疗MPP患儿的临床疗效更显著,可有效调节患儿体液免疫和细胞免疫,促进恢复,且安全可靠。

Objective To observe the clinical efficacy and safety of budesonide aerosol inhalation in treatment of children with mycoplasma pneumoniae pneumonia(MPP).Methods The patients with severe MPP were randomly divided into control group and treatment group.The control group received basic therapy such as antipyretic,relieving cough,expectorant,oxygen inhalation and bronchiectasis,as well as intravenous infusion of 10 mg·kg^(-1)azithromycin,qd,and then changed to oral administration 5 mg·kg^(-1)azithromycin tablets for 5 consecutive days,qd.The patients in the treatment group received budesonide(2 mL per time,bid)atomization inhalation adjuvant therapy on the basis of the control group.Both groups were treated for 2 consecutive weeks.The clinical efficacy,serum inflammatory index levels,serum immunoglobulin index levels,fever subsidence time,coughdisappearance time were compared between the two groups,and the occurrence of adverse drug reactions in patients wasobserved.Results Finally,there were 30 patients in the treatment group and 30 cases in the control group,and nopatients dropped out the trial.After treatment,the total effective rates of the control group and the treatment group were73.33%and 93.33%,respectively,the difference was statistically significant(P<0.05).The levels of interleukin-2(IL-2)in the treatment and control groups were(262.11±40.26)and(172.51±27.18)ng·L^(-1),respectively;the levels of interferon-α(INF-α)were(7.80±2.15)and(4.31±0.87)ng·L^(-1),respectively;the levels ofimmunoglobulin A(IgA)were(0.70±0.35)and(0.53±0.18)g·L^(-1),respectively;the levels of IgM were(1.32±0.27)and(0.96±0.19)g·L^(-1),respectively;the duration of fever reduction was(5.22±1.24)and(3.62±1.09)d,respectively;the cough disappearance time was(7.51±1.35)and(5.90±1.24)d,respectively.The above indicators of the treatment group compared with the control group,the difference wasstatistically significant(allP<0.05).The total incidences of adverse drug reactions in the treatment group and thecontrol group were 13.33%(4 cases/30 cases)and 10.00%(3 cases/30 cases),respectively,with no significantdifference(P>0.05).Conclusion The clinical efficacy of budesonide aerosol inhalation adjuvant therapy forchildren with MPP is more significant,it can effectively regulate the humoral immunity and cellular immunity ofpatients,and promote recovery.It is safe and reliable.