两种糖皮质激素给药方式治疗婴幼儿哮喘急性发作的疗效比较
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摘要
目的探讨两种糖皮质激素给药方式治疗婴幼儿哮喘急性发作的疗效。方法选取2016年8月至2017年12月于大石桥市中心医院接受治疗的哮喘急性发作婴幼儿90例作为研究对象,按照治疗方式不同将其分为观察组(45例)与对照组(45例)。对照组患儿采用醋酸泼尼松片口服治疗,观察组患儿采用布地奈德混悬液雾化吸入治疗。比较两组患儿临床症状消失时间、嗜酸性粒细胞、白细胞介素-4(IL-4)、免疫球蛋白E(IgE)、外周血T细胞亚群。结果观察组患儿咳嗽消失时间、呼吸困难消失时间、痰鸣音消失时间、喘息消失时间与对照组比较差异均无统计学意义(均P>0.05)。治疗后观察组患者嗜酸性粒细胞、IgE、IL-4均显著低于对照组(均P<0.05),而外周血T细胞亚群与对照组比较差异无统计学意义(P>0.05)。结论婴幼儿哮喘急性发作期运用糖皮质激素口服以及雾化吸入两种给药方式治疗效果相当,但雾化吸入治疗方式对患儿的嗜酸性粒细胞、IgE、IL-4等相关指标的改善更具优势。
Objective To explore the efficacy of 2 glucocorticoid administration methods in the treatment of acute attack of asthma in infants. Methods A total of 90 infants with acute asthma attack treated in the Dashiqiao Central Hospital from August 2016 to December 2017 were selected as the study subjects. According to different treatment methods, they were divided into observation group(45 cases) and control group(45 cases). The control group was treated with prednisone acetate tablets orally. The observation group was treated with aerosol inhalation of budesonide suspension. Disappearance time of clinical symptoms, eosinophils, IL-4, IgE and T lymphocyte subsets in peripheral blood were compared between the 2 groups. Results There were no significant differences in cough disappearance time, dyspnea disappearance time, sputum sounds disappearance time and wheezing disappearance time between the observation group and the control group(P>0.05). After the treatment, the eosinophils, IgE and IL-4 in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in the T lymphocyte subsets in peripheral blood compared with that of the control group(P>0.05). Conclusion The therapeutic effects of oral administration and aerosol inhalation of glucocorticoids in acute attack of infantile asthma are comparable, but aerosol inhalation treatment has more advantages in improving eosinophils, IgE, IL-4 and other related indicators of infantile asthma.
Objective To explore the efficacy of 2 glucocorticoid administration methods in the treatment of acute attack of asthma in infants. Methods A total of 90 infants with acute asthma attack treated in the Dashiqiao Central Hospital from August 2016 to December 2017 were selected as the study subjects. According to different treatment methods, they were divided into observation group(45 cases) and control group(45 cases). The control group was treated with prednisone acetate tablets orally. The observation group was treated with aerosol inhalation of budesonide suspension. Disappearance time of clinical symptoms, eosinophils, IL-4, IgE and T lymphocyte subsets in peripheral blood were compared between the 2 groups. Results There were no significant differences in cough disappearance time, dyspnea disappearance time, sputum sounds disappearance time and wheezing disappearance time between the observation group and the control group(P>0.05). After the treatment, the eosinophils, IgE and IL-4 in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in the T lymphocyte subsets in peripheral blood compared with that of the control group(P>0.05). Conclusion The therapeutic effects of oral administration and aerosol inhalation of glucocorticoids in acute attack of infantile asthma are comparable, but aerosol inhalation treatment has more advantages in improving eosinophils, IgE, IL-4 and other related indicators of infantile asthma.
引文
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[6]高佩琦,孙永法,胡姬婷.高剂量雾化吸入糖皮质激素治疗儿童重度哮喘急性发作的疗效分析[J].现代诊断与治疗,2017,28(10):1810-1811.
[7]张绍新,郭玲凌.糖皮质激素不同给药方式治疗慢性阻塞性肺疾病急性加重期的效果和安全性研究[J].中国当代医药,2017,24(23):46-48,65.
[8]张茂姬,罗敏.醋酸泼尼松片和注射用氢化可的松琥珀酸钠致过敏反应1例[J].中国药物警戒,2017,14(4):255-256.
[9]陈小青.口服泼尼松联合丙卡特罗治疗婴幼儿哮喘疗效观察[J].现代中西医结合杂志,2014,23(8):856-858.
[10]李娅宁,王蕾,耿磊,等.布地奈德联合不同药物雾化吸入治疗儿童哮喘疗效比较[J].中国医院药学杂志,2017,37(6):533-537.
[11]杨秋丽,郑小翠.雾化吸入布地奈德治疗小儿急性感染性喉炎的临床疗效及安全性评价[J].安徽医药,2017,21(1):140-143.
[12]卢国煊.异丙托溴铵与布地奈德加特布他林雾化吸入在儿童中重度支气管哮喘急性发作治疗中的应用[J].吉林医学,2017,38(2):354-355.
[2]王鹏.支气管哮喘药物治疗现状及进展分析[J].实用中西医结合临床,2018,18(3):176-177.
[3]中华医学会儿科学会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.
[4]张晓颖,陈巍,康勤洪,等.糖皮质激素两种给药方式治疗婴幼儿哮喘急性发作的疗效比较[J].中国药房,2016,27(32):4577-4579.
[5]Mincheva R,Ekerljung L,Bossios A,et al.重症哮喘的高患病率:一项大型随机人群研究[J].中华临床免疫和变态反应杂志,2018,12(5):575-582.
[6]高佩琦,孙永法,胡姬婷.高剂量雾化吸入糖皮质激素治疗儿童重度哮喘急性发作的疗效分析[J].现代诊断与治疗,2017,28(10):1810-1811.
[7]张绍新,郭玲凌.糖皮质激素不同给药方式治疗慢性阻塞性肺疾病急性加重期的效果和安全性研究[J].中国当代医药,2017,24(23):46-48,65.
[8]张茂姬,罗敏.醋酸泼尼松片和注射用氢化可的松琥珀酸钠致过敏反应1例[J].中国药物警戒,2017,14(4):255-256.
[9]陈小青.口服泼尼松联合丙卡特罗治疗婴幼儿哮喘疗效观察[J].现代中西医结合杂志,2014,23(8):856-858.
[10]李娅宁,王蕾,耿磊,等.布地奈德联合不同药物雾化吸入治疗儿童哮喘疗效比较[J].中国医院药学杂志,2017,37(6):533-537.
[11]杨秋丽,郑小翠.雾化吸入布地奈德治疗小儿急性感染性喉炎的临床疗效及安全性评价[J].安徽医药,2017,21(1):140-143.
[12]卢国煊.异丙托溴铵与布地奈德加特布他林雾化吸入在儿童中重度支气管哮喘急性发作治疗中的应用[J].吉林医学,2017,38(2):354-355.