单磷酸阿糖腺苷治疗毛细支气管炎

Therapeutic effect of vidarabine monophosphate in the treatment of bronchiolitis

目的探讨单磷酸阿糖腺苷治疗毛细支气管炎患儿的效果。方法选择122例毛细支气管炎患儿,根据入院顺序随机分为观察组与对照组,各61例。对照组接受吸入用布地奈德混悬液、复方异丙托溴铵溶液治疗,观察组在对照组基础上接受注射用单磷酸阿糖腺苷治疗。2组均治疗7 d。观察2组治疗7 d后的疗效,记录2组临床指标变化情况,比较2组治疗前、治疗7 d后肺功能指标、血清淀粉蛋白A(SAA)、白三烯E4(LTE4)、单核细胞趋化蛋白-1(MCP-1)水平及治疗期间不良反应发生率。结果治疗7 d后,观察组总有效率(93.44%,57/61)高于对照组(80.33%,49/61)(P<0.05)。观察组喘息、湿啰音、咳嗽消失及住院时间短于对照组(P<0.05)。治疗7 d后,2组达峰时间比(TPTEF/TE)、潮气量(TV)水平高于治疗前,且观察组高于对照组;2组血清SAA、LTE4、MCP-1、吸呼时间比(TI/TE)水平低于治疗前,观察组低于对照组(P均<0.05)。治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论毛细支气管炎患儿在布地奈德、复方异丙托溴铵治疗后给予单磷酸阿糖腺苷联合治疗可降低血清SAA、LTE4、MCP-1水平,明显改善患儿肺功能及临床症状,提高疗效,缩短住院时间,安全性良好。

Objective To explore therapeutic effect of vidarabine monophosphate on children with bronchiolitis.Methods 122 children with bronchiolitis were selected and randomly divided into the observation group and the control group according to the order of admission,with 61 cases in each group.The control group received budesonide suspension for inhalation and compound ipratropium bromide solution for inhalation,while the observation group received vidarabine monophosphate for injection on the basis of the treatment of the control group.Both groups were treated for 7 days.The curative effects of two groups were observed after 7 days of treatment.The changes of the levels of clinical indexes of two groups were recorded.The lung function indexes,levels of serum amyloid A(SAA),leukotriene E4(LTE4)and monocyte chemoattractant protein-1(MCP-1)before treatment and after 7 days of treatment,and incidence of adverse reactions during treatment between two groups were compared.Results After 7 days of treatment,the total effective rate in the observation group(93.44%,57/61)was higher than that in the control group(80.33%,49/61)(P<0.05).Wheezer,moist rales,cough disappearance time,and hospital stay in the observation group were shorter than those in the control group(P<0.05).After 7 days of treatment,levels of time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),and tidal volume(TV)in both grups were higher than those before treatment,and the observation group was higher than the control group;Levels of serum SAA,LTE4 and MCP-1,and inspiration time/expiratory time(TI/TE)in both grups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).During the treatment,there was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion After treatment with budesonide and compound ipratropium bromide,combined treatment with vidarabine monophosphate can reduce the levels of serum SAA,LTE4 and MCP-1,and significantly improve lung function and clinical symptoms in children with bronchiolitis.This therapy can improve efficacy,shorten hospitalization time,and has good safety.