布地奈德与阿莫西林克拉维酸钾联合治疗对肺炎患儿肺功能与炎症指标的改善效果

Effect of Combination Therapy with Budesonide and Amoxicillin Clavulanate Potassium on Improving Pulmonary Function and Inflammatory Indexes in Children with Pneumonia

目的探讨布地奈德与阿莫西林克拉维酸钾联合治疗对肺炎患儿肺功能、炎症指标的改善效果。方法选取2021年3月至2022年3月瑞金市人民医院收治的肺炎患儿70例作为研究对象,根据治疗方法不同分为常规组和试验组,各35例。常规组给予阿莫西林克拉维酸钾治疗,试验组给予布地奈德与阿莫西林克拉维酸钾联合治疗。比较两组患儿临床症状消失时间,治疗前后肺功能、炎症指标及免疫功能指标变化。结果试验组肺部啰音、发热、气喘、咳嗽、咳痰消失时间显著短于常规组(P<0.05)。治疗前两组肺功能指标比较差异无统计学意义(P>0.05);治疗后两组呼气峰流速(PEF)、用力肺活量(FVC)、第一秒钟用力呼气容积(FEV_(1))显著提高,且试验组PEF、FVC、FEV_(1)改善更明显,差异有统计学意义(P<0.05)。治疗前两组炎症因子水平比较差异无统计学意义(P>0.05);治疗后两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、中性粒细胞与淋巴细胞比率(NLR)、降钙素原(PCT)水平显著下降,且试验组下降幅度更大,差异有统计学意义(P<0.05)。治疗前两者免疫功能指标水平比较差异无统计学意义(P>0.05);治疗后两组CD3^(+)、CD8^(+)水平低于治疗前,CD4^(+)、CD4^(+)/CD8^(+)高于治疗前,且试验组优于常规组,差异有统计学意义(P<0.05)。结论对肺炎患儿采用布地奈德与阿莫西林克拉维酸钾联合治疗能够显著降低炎症指标水平,改善肺功能和免疫功能。

Objective To explore the effect of budesonide combined with amoxicillin and clavulanate potassium on improving pulmonary function and inflammation in children with pneumonia.Methods Seventy children with pneumonia treated in Ruijin People's Hospital from March 2021 to March 2022 were selected as the study objects,and were divided into conventional group and experimental group according to different treatment methods,with 35 cases in each group.The conventional group was given amoxicillin and clavulanate potassium treatment,and the experimental group was given budesonide and amoxicillin and clavulanate potassium combined treatment.The time for clinical symptoms to disappear and the changes of lung function,inflammatory index and immune function index before and after treatment were compared between the two groups.Results The disappearance time of pulmonary rales,fever,asthma,cough and expectoration in experimental group was significantly shorter than that in conventional group(P<0.05).There was no significant difference in lung function index between the two groups before treatment(P>0.05).After treatment,the peak expiratory flow rate(PEF),forced vital capacity(FVC)and forced expiratory volume in the first second(FEV_(1))of the two groups were significantly increased,and the improvement of PEF,FVC and FEV_(1) of the experimental group was more obvious,with statistical significance(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before treatment(P>0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),neutrophil to lymphocyte ratio(NLR)and procalcitonin(PCT)in 2 groups were significantly decreased,and the decrease in experimental group was greater,with statistical significance(P<0.05).There was no significant difference in the level of immune function indexes between the two groups before treatment(P>0.05).After treatment,the levels of CD3^(+) and CD8^(+) in both groups were lower than before treatment,and CD4^(+)and CD4^(+)/CD8^(+) were higher than before treatment,and the experimental group was better than the conventional group,the difference was statistically significant(P<0.05).Conclusion The combination of budesonide and amoxicillin and clavulanate potassium in children with pneumonia can significantly reduce the level of inflammatory markers,improve lung function and immune function.