盐酸氨溴索联合乙酰半胱氨酸雾化吸入治疗小儿支气管肺炎的疗效及对患儿支气管黏膜纤毛结构及炎症因子的影响

The efficacy of ambroxol hydrochloride combined with acetylcysteine nebulized inhalation in the treatment of children with bronchial pneumonia and its influence on bronchial mucosa cilia structure and inflammatory factors

目的探讨盐酸氨溴索联合乙酰半胱氨酸雾化吸入治疗小儿支气管肺炎的疗效及对患儿支气管黏膜纤毛结构及炎症因子的影响。方法选取2019年7月至2021年7月山东省妇幼保健院收治的116例支气管肺炎患儿作为研究对象,随机分为对照组与研究组,每组58例。对照组给予盐酸氨溴索雾化吸入治疗,研究组在对照组的基础上联合乙酰半胱氨酸雾化吸入治疗。比较两组临床疗效、临床症状消失时间、炎症因子水平及支气管黏膜纤毛结构变化。结果研究组治疗总有效率为96.55%,高于对照组的84.48%,差异有统计学意义(P<0.05)。研究组咳嗽消失时间、发热消失时间、喘息消失时间、肺部湿啰音消失时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、可溶性细胞间黏附分子-1(sICAM-1)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组复合纤毛、鳞状上皮化生占比均低于对照组,差异有统计学意义(P<0.05)。两组动力蛋白壁缺失、纤毛数量异常占比比较差异无统计学意义。结论盐酸氨溴索联合乙酰半胱氨酸雾化吸入治疗小儿支气管肺炎的临床疗效显著,可有效缓解患儿临床症状,减轻机体炎症反应,并有利于支气管黏膜纤毛结构恢复正常。

Objective To investigate the efficacy of ambroxol hydrochloride combined with acetylcysteine nebulized inhalation in the treatment of children with bronchial pneumonia and its influence on bronchial mucosa cilia structure and inflammatory factors.Methods A total of 116 chil-dren with bronchial pneumonia admitted to Shandong Maternal and Child Health Hospital from July 2019 to July 2021 were selected as the research subjects,and they were randomly divided into the control group and the study group,with 58 cases in each group.The control group received nebu-lized inhalation of ambroxol hydrochloride,while the study group received nebulized inhalation of acetylcysteine on the basis of the control group.The clinical efficacy,disappearance time of clinical symptoms,levels of inflammatory factors and changes of bronchial mucosa cilia structure were compared between the two groups.Results The total effective rate in the study group was 96.55%,which was higher than 84.48%in the control group,the difference was statistically significant(P<0.05).The disappearance time of cough,fever,wheezing and pulmonary moist rales in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of interleukin-6(IL-6),C-reactive protein(CRP)and soluble intercellular adhesion molecule-1(sICAM-1)of the two groups were lower than those before treatment,and the study group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the proportion of compound cilia and squamous metaplasia in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the proportion of dynein wall deletion and abnormal cilia between the two groups.Conclusion Ambroxol hydrochloride combined with acetylcysteine nebulized inhalation is effective in the treatment of children with bron-chial pneumonia,which can effectively relieve the clinical symptoms of children,alleviate the body's inflammatory response,and is beneficial to the recovery bronchial mucosa cilia structure.