阿莫西林克拉维酸钾联合布地奈德雾化吸入对喘息性肺炎患儿肺功能及血清HMGB1、PCT的影响

Influence of amoxicillin and clavulanate potassium combined with budesonide atomization inhalation on pulmonary function and serum HMGB1 and PCT in children with asthmatic pneumonia

目的:探究阿莫西林克拉维酸钾和布地奈德雾化吸入联合治疗小儿喘息性肺炎的效果及对患儿肺功能、血清高迁移率族蛋白B1(Serum high mobility group protein B1,HM GB1)、降钙素原(Procalcitonin,PCT)的影响。方法:选取2021年1月至2023年5月我院收治的66例小儿喘息性肺炎患者作为研究对象,采用随机信封法分为雾化组和联用组,各33例。雾化组吸入雾化的布地奈德治疗,联用组在雾化组的基础上加用阿莫西林克拉维酸钾治疗。治疗10 d后,比较两组疗效、症状缓解时间、住院时间、炎症指标(HMGB1、PCT)、肺功能指标[潮气量与体重之比(Ratio of tidal volume to body weight,VT/kg)、呼气流量峰值时间与总呼气时间之比(Ratio of time to peak tidal expiratory flow to total expiratory time,TPTEF/TE)、呼气流量峰值与总呼气流量之比(Ratio of volume to peak expiratory flow to total expiratory volume,VPEF/VE)]和不良反应情况。结果:治疗10 d后,联用组总有效率明显高于雾化组(P<0.05);联用组患儿气促缓解时间、咳嗽消失时间、啰音消失时间以及住院时长均短于雾化组(P<0.05);两组患儿治疗后的血清HMGB1与PCT水平均较前降低,且联用组均低于雾化组(P<0.05);两组患儿治疗后的VT/kg、TPTEF/TE、VPEF/VE水平均较前升高,且联用组均高于雾化组(P<0.05);两组不良反应发生率无明显差异(P>0.05)。结论:阿莫西林克拉维酸钾和布地奈德雾化吸入联合治疗小儿喘息性肺炎效果显著,能缩短症状缓解时间和住院时间,改善炎症因子水平和肺功能,且不会加重不良反应,安全性高。

Objective:To explore the effect of the combination of amoxicillin and clavulanate potassium and budesonide atomization inhalation on asthmatic pneumonia in children and the influence on pulmonary function,serum high mobility group protein B1(HMGB1)and procalcitonin(PCT).Methods:Sixty-six children with asthmatic pneumonia in the hospital were selected from January 2021 to May 2023 as the study subjects,and were divided into atomization group(n=33)and combination group(n=33)by using the random envelope method.The atomization group was treated with atomization inhalation of budesonide,while the combination group was added with amoxicillin and clavulanate potassium based on atomization group.After 10 days of treatment,the efficacy,symptom relief time,hospital stay,inflammatory indicators(HMGB1,PCT),and pulmonary function indicators[ratio of tidal volume to body weight(VT/kg),time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),volume to peak expiratory flow as a proportion of exhaled volume(VPEF/VE)]and adverse reactions were compared between groups.Results:After 10 days of treatment,the total effective rate in combination group was 93.94%,which was significantly higher than 75.76%in atomization group(P<0.05).The relief time of shortness of breath,disappearance time of cough,disappearance time of rales,and hospital stay in combination group were shorter than those in atomization group(P<0.05).The levels of serum HMGB1 and PCT were decreased in both groups after treatment compared to before treatment,and the levels in combination group were lower than those in atomization group(P<0.05).The VT/kg,TPTEF/TE and VPEF/VE in both groups were increased compared with those before treatment,and the combination group had higher VT/kg,TPTEF/TE and VPEF/VE(P<0.05).There was no obvious difference in the incidence of adverse reactions between both groups(P>0.05).Conclusion:The combination of amoxicillin and clavulanate potassium and budesonide atomization inhalation has a significant effect in the treatment of asthmatic pneumonia in children.It can shorten the symptom relief time and hospital stay and improve the levels of inflammatory factors,and it does not exacerbate adverse reactions,with high safety.