盐酸氨溴索辅助治疗新生儿感染性肺炎的疗效与相关药理机制研究

Pharmacological mechanism and curative effect of ambroxol hydrochloride in the treatment of neonatal infectious pneumonia

目的探讨盐酸氨溴索辅助治疗新生儿感染性肺炎的疗效与相关药理机制,为新生儿感染性肺炎的临床诊治与用药提供参考。方法选取2017年6-12月医院收治的感染性肺炎新生儿100例为研究对象,随机分为对照组与研究组,每组50例,两组患儿均给与常规的吸氧、抗感染、维持酸碱度平衡及对症、支持治疗,研究组在以上基础上加用盐酸氨溴索静脉滴注及雾化吸入治疗,7 d为一个疗程。观察患儿治疗前和治疗3 d时血气指标氧分压(PaO2)和二氧化碳分压(PaCO2)、血清白细胞介素-2(IL-2)、IL-6、IL-10、C-反应蛋白(CRP)情况,治疗期间发热、气喘、呼吸困难改善时间,并评价治疗疗效。结果治疗3 d时研究组患儿PaO2为(67.02±6.71)mmHg高于对照组(P<0.001),PaCO2为(44.33±2.15)mmHg低于对照组(P<0.001);治疗3 d时研究组IL-2为(26.41±5.25)pg/ml高于对照组(P<0.001),IL-6、IL-10、CRP为(176.56±32.18)ng/L、(15.11±3.07)ng/L、(15.48±5.43)mg/L低于对照组(P<0.001);研究组患儿发热、气喘、呼吸困难明显改善时间分别为(4.12±1.07)d、(5.07±1.81)d、(3.03±1.15)d短于对照组(P<0.001);研究组疗效优于对照组(P=0.027)。结论盐酸氨溴索具有多重药理作用,辅助治疗新生儿感染性肺炎有助于快速改善动脉血气及减轻炎性反应,缩短病程,具有一定的临床价值。

OBJECTIVE To investigate the pharmacological mechanism and curative effect of ambroxol hydrochloride in the treatment of neonatal infectious pneumonia,so as to provide reference for diagnosis and treatment of neonatal infectious pneumonia.METHODS The 100 cases of child patients with neonatal infectious pneumonia treated in the hospital form Jun.-Dec.2017 were enrolled and randomly divided into the control group and research group,with 50 cases in each group.Both groups were given routine clinical treatment such as oxygen inhalation,anti-infection,maintenance of electrolyte disorder,as well as symptomatic and supportive treatment.The research group was additionally treated with intravenous infusion and atomized inhalation of ambroxol hydrochloride,with 7 days as a course of treatment.The changes of PaO2,PaCO2,IL-2,IL-6,IL-10,CRP prior to treatment and 3d after treatment,as well as time taken to improve pyrexia,asthma,breathing difficulty during the treatment were compared between the two groups,and the clinical efficacy was evaluated.RESULTS The PaO2 level of the research group was(67.02±6.71)mmHg 3d after treatment,significantly higher than that of the control group(P<0.001),PaCO2 of the research group was(44.33±2.15)mmHg 3d after treatment,significantly lower than that of the control group(P<0.001).IL-2 of the research group was(26.41±5.25)pg/ml 3d after treatment,significantly higher than that of the control group(P<0.001),IL-6,IL-10 and CRP of the research group were(176.56±32.18)ng/L,(15.11±3.07)ng/L,and(15.48±5.43)mg/L 3d after treatment,respectively,which were significantly lower than those of the control group(P<0.001).The time taken to improve pyrexia,asthma,breathing difficulty of the research group were(4.12±1.07)d and(5.07±1.81)d and(3.03±1.15)d,significantly lower than those of the control group(P<0.001).The clinical efficacy of the research group was significantly better than the control group(P=0.027).CONCLUSION Ambroxol hydrochloride has multiple pharmacological functions,which can rapidly improve arterial blood gas,reduce inflammation and shorten the course of illness in the treatment of neonatal infectious pneumonia.Therefore,it has a certain clinical value.