布地奈德联合阿奇霉素治疗支气管肺炎患儿的临床效果

Clinical Efficacy of Budesonide Combined With Azithromycin in the Treatment of Children With Bronchopneumonia

目的探究布地奈德雾化吸入联合阿奇霉素治疗支气管肺炎患儿,对其临床症状及炎症因子水平的影响。方法选择莆田学院附属医院2021年7月—2022年7月收治的支气管肺炎患儿75例,采用随机数表法分为对照组(n=38)与观察组(n=37)。对照组采用阿奇霉素治疗,观察组采用布地奈德雾化吸入联合阿奇霉素治疗。观察并比较2组患儿咳嗽、发热、气促、发绀等症状消失时间,治疗前后血清白细胞介素(interleukin-6,IL-6)、γ干扰素(γinterferon,IFN-γ)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C-反应蛋白(C-reactive protein,CRP)水平,用力肺活量(forced vital capacity,FVC)、FVC与第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))比值(FEV_(1)/FVC),并统计不良反应发生情况。结果观察组咳嗽、发热、气促、发绀症状消失时间[(3.48±0.68)d、(1.89±0.43)d、(2.68±0.55)d、(4.52±1.17)d]短于对照组[(4.08±0.79)d、(2.33±0.66)d、(3.15±0.87)d、(5.23±1.33)d],差异有统计学意义(P<0.05)。治疗前,2组细胞因子水平比较,差异无统计学意义(P>0.05);治疗后,2组IL-6、IFN-γ、TNF-α、CRP水平均低于治疗前,且观察组IL-6、IFN-γ、TNF-α、CRP水平[(13.03±2.05)ng/L、(20.21±3.34)ng/mL、(24.34±4.01)pg/mL、(22.36±3.35)mg/L]均低于对照组[(15.12±2.12)ng/L、(22.36±3.73)ng/mL、(28.52±4.72)pg/mL、(25.02±3.88)mg/L],差异有统计意义(P<0.05)。治疗后,治疗后,观察组FEV_(1)、FEV_(1)/FVC高于治疗前,且观察组[(0.96±0.11)L、(67.68±9.56)%]高于对照组[(0.88±0.10)L、(62.32±8.62)%],差异有统计学意义(P<0.05)。治疗结束后发现观察组治疗期间不良反应发生率为13.51%,与对照组(10.53%)比较,差异无统计学意义(P>0.05)。结论应用布地奈德雾化吸入联合阿奇霉素治疗支气管肺炎患儿能有效缓解其临床症状,调控炎症反应并改善肺部功能,且用药安全性较高。

Objective To investigate the effect of budesonide aerosol inhalation combined with azithromycin on clinical symptoms and inflammatory cytokine levels in children with bronchopneumonia.Methods A total of 75 children with bronchopneumonia admitted to the Affiliated Hospital of Putian University from July 2021 to July 2022 were randomly divided into a control group(n=38)and a observation group(n=37)by random number table method.The control group was treated with azithromycin,while the observation group was treated with budesonide nebulized inhalation combined with azithromycin.The disappearance time of symptoms such as cough,fever,shortness of breath,and cyanosis between two groups were observed and compared,as well as the serum interleukin-6(IL-6)levels,γinterferon(IFN-γ),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)levels,forced vital capacity(FVC),FVC to forced expiratory volume in one second(FEV_(1)/FVC)ratio before and after treatment,and incidence of adverse reactions were recorded.Results The disappearance time of symptoms such as cough,fever,shortness of breath,and cyanosis in the observation group[(3.48±0.68)d,(1.89±0.43)d,(2.68±0.55)d,(4.52±1.17)d]were significantly shorter than those in the control group[(4.08±0.79)d,(2.33±0.66)d,(3.15±0.87)d、(5.23±1.33)d],and there were significant differences between the groups(P<0.05).Before treatment,the cytokine levels in both groups of patients were similar(P>0.05).After treatment,IL-6 and IFN-γ、TNF-α、The CRP levels were significantly reduced(P<0.05),and the levels of IL-6,IFN-γ,TNF-α,and CRP in the observation group[(13.03±2.05)ng/L,(20.21±3.34)pg/mL,(24.34±4.01)ng/mL、(22.36±3.35)mg/L]were lower than those in the control group[(15.12±2.12)ng/L,(22.36±3.73)pg/mL,(28.52±4.72)ng/mL,(25.02±3.88)mg/L],with statistical significance(P<0.05).After treatment,the FEV_(1) level and FEV_(1)/FVC in the observation group were higher than before treatment,and the observation group[(0.96±0.11)L、(67.68±9.56)%]was better than the control group[(0.88±0.10)L、(62.32±8.62)%],with significant differences(P<0.05).After treatment,it was found that the incidence of adverse reactions during the treatment period in the observation group was 13.51%,and there was no statistically significant difference compared to the control group(10.53%)(P>0.05).Conclusion Budesonide nebulized inhalation combined with azithromycin can effectively control the condition of children with bronchopneumonia,improve lung function,reduce inflammatory factor levels,and the treatment process is safe and reliable.