布地奈德吸入治疗联合奥马珠单抗注射对中重度支气管哮喘患儿的治疗效果研究

Study on the therapeutic effect of budesonide inhalation combined with omalizumab injection in children with moderate to severe bronchial asthma

目的探讨布地奈德吸入治疗联合奥马珠单抗注射在中重度支气管哮喘患儿中的应用效果。方法选取2020年1月—2024年1月邯郸市妇幼保健院收治的98例中重度支气管哮喘患儿为研究对象,采用随机数字表法分为对照组和观察组,各49例。对照组接受布地奈德混悬液雾化吸入治疗,观察组接受布地奈德联合奥马珠单抗治疗,均治疗4个月。比较两组患儿临床症状(咳嗽、喘息、呼吸困难、肺部湿啰音)消退时间;比较两组患儿治疗前后血清炎症因子[外周血嗜酸性粒细胞计数(EOS)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平、肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、呼气峰值流量(PEF)];比较两组患儿治疗前、治疗1个月、2个月和4个月后的免疫功能[免疫球蛋白(Ig)G、IgA、IgE]、哮喘控制评分和哮喘生活质量评分;记录不良反应(恶心呕吐、嗜睡、下肢水肿、皮疹)发生情况。结果两组患儿咳嗽、喘息、呼吸困难和肺部湿啰音消失时间的比较,差异均有统计学意义(P<0.05)。观察组治疗前后EOS、hs-CRP、IL-6、FVC、FEV1、PEF差值均高于对照组(P<0.05)。两组患儿治疗前、治疗1个月、2个月和4个月后的IgG、IgA、IgE比较,结果:①不同时间点的IgG、IgA、IgE比较,差异均有统计学意义(P<0.05);②两组的IgG、IgA、IgE比较,差异均有统计学意义(P<0.05);③两组IgG、IgA、IgE变化趋势比较,差异均有统计学意义(P<0.05)。两组治疗前、治疗1个月、2个月和4个月后的哮喘控制评分和生活质量评分比较,结果:①不同时间点的哮喘控制评分和生活质量评分比较,差异均有统计学意义(P<0.05);②两组哮喘控制评分和生活质量评分比较,差异均有统计学意义(P<0.05);③两组哮喘控制评分和生活质量评分变化趋势比较,差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论布地奈德联合奥马珠单抗能提高中重度支气管哮喘患儿的治疗效果,且联合用药不会增加不良反应风险。

Objective To investigate the effectiveness of budesonide inhalation therapy combined with omalizumab injection in children with moderate to severe bronchial asthma.Methods A total of 98 children with moderate to severe bronchial asthma admitted to Handan Maternal and Child Health Hospital from January 2020 to January 2024 were selected for this study.They were randomly divided into a control group and an observation group,with 49 cases in each group.The control group received budesonide suspension inhalation therapy,while the observation group received budesonide combined with omalizumab treatment for 4 months.The time to resolution of clinical symptoms(cough,wheezing,shortness of breath,lung wet rales)was compared between the two groups.Additionally,serum inflammatory factor levels[eosinophil count(EOS),high-sensitivity C-reactive protein(hsCRP),interleukin-6(IL-6)]and pulmonary function[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF)]before and after treatment were compared.The immune function[immunoglobulin(Ig)G,IgA,IgE],asthma control scores,and asthma quality of life scores were assessed before treatment and at 1 month,2 months,and 4 months after treatment.Adverse reactions(nausea,vomiting,drowsiness,lower limb edema,rash)were recorded.Results The time for the resolution of cough,wheezing,shortness of breath,and lung wet rales was significantly shorter in the observation group compared to the control group(P<0.05).The changes in EOS,hs-CRP,IL-6,FVC,FEV_(1),and PEF in the observation group before and after treatment were greater than those in the control group(P<0.05).Comparison of IgG,IgA,and IgE levels before treatment,and at 1 month,2 months,and 4 months after treatment between the observation and control groups showed:(1)statistically significant differences at different time points for IgG,IgA,and IgE(P<0.05).(2)significant differences between the observation and control groups for IgG,IgA,and IgE(P<0.05).(3)The trends of changes in IgG,IgA,and IgE showed significant differences between the groups(P<0.05).The comparison of asthma control scores and quality of life scores before treatment,and at 1 month,2 months,and 4 months after treatment between the observation and control groups indicated:(1)significant differences at different time points for asthma control scores and quality of life scores(P<0.05).(2)significant differences between the observation and control groups(P<0.05).(3)The trends of changes in asthma control scores and quality of life scores also showed significant differences(P<0.05).The overall incidence of adverse reactions did not differ significantly between the two groups(P>0.05).Conclusion Budesonide combined with omalizumab significantly improves the treatment outcomes in children with moderate to severe bronchial asthma without increasing the risk of adverse reactions.