布地奈德和沙丁胺醇雾化吸入对小儿支气管肺炎的治疗效果
|
摘要
为了探讨布地奈德和沙丁胺醇雾化吸入对小儿支气管肺炎的治疗效果,本研究选取138例小儿支气管肺炎患儿随机分组,对照组患儿应用布地奈德治疗,试验组患儿给予布地奈德联合沙丁胺醇治疗,观察比较两组患儿TGF-β1、CRP水平、肺功能水平、临床症状消失时间差异。研究结果表明,治疗后试验组患儿TGF-β1 (1.50±0.46)μg/mL、CRP (12.01±0.97)μg/mL较对照组明显下降(p<0.05);治疗后试验组患儿FEV1(2.68±0.86) L、FEV1/FVC (85.67±8.65)%、PEF变异率(12.04±1.59)%较对照组比较明显改善(p<0.05);试验组患儿咳嗽持续时间(4.49±0.35) d、啰音持续时间(5.79±0.51) d、发热持续时间(2.18±0.24) d、肺部X线阴影持续时间(6.16±0.63) d同对照组比较明显缩短(p<0.05)。本研究初步表明,针对小儿支气管肺炎患儿应用布地奈德和沙丁胺醇雾化吸入治疗可有效改善临床症状和通气功能,改善临床指标,促进患儿康复,值得推广应用。
To investigate the therapeutic effect of budesonide and salbutamol inhalation on bronchopneumonia in children. In this study, 138 children with pediatric bronchoppneumonia were randomly assigned into two groups.Children in the control group were treated with budesonide, and children in the experimental group were treated with budesonide and salbutamol. Differences in TGF-1, CRP level, lung function level, and clinical symptom disappearance time between the two groups were observed and compared. The results showed that TGF-1(1.50±0.46) g/mL and CRP(12.01±0.97) g/mL in the experimental group were significantly lower than those in the control group(p<0.05). After treatment, FEV1(2.68±0.86) L, FEV1/FVC(85.67±8.65)% and PEF variation rate(12.04±1.59)% in the experimental group were significantly improved compared with the control group(p<0.05). The duration of cough(4.49±0.35) d, duration of ranitis(5.79±0.51) d, duration of fever(2.18±0.24) d and duration of lung X-ray shadow(6.16±0.63) d in the experimental group were significantly shorter than those in the control group(p<0.05).Our preliminary study showed that aerosol inhalation of budesonide and salbutamol for children with bronchopneumonia can effectively improve clinical symptoms and respiratory function, and enhance clinical index, and promote the recovery of children, which is worthy of promotion and application in practise.
To investigate the therapeutic effect of budesonide and salbutamol inhalation on bronchopneumonia in children. In this study, 138 children with pediatric bronchoppneumonia were randomly assigned into two groups.Children in the control group were treated with budesonide, and children in the experimental group were treated with budesonide and salbutamol. Differences in TGF-1, CRP level, lung function level, and clinical symptom disappearance time between the two groups were observed and compared. The results showed that TGF-1(1.50±0.46) g/mL and CRP(12.01±0.97) g/mL in the experimental group were significantly lower than those in the control group(p<0.05). After treatment, FEV1(2.68±0.86) L, FEV1/FVC(85.67±8.65)% and PEF variation rate(12.04±1.59)% in the experimental group were significantly improved compared with the control group(p<0.05). The duration of cough(4.49±0.35) d, duration of ranitis(5.79±0.51) d, duration of fever(2.18±0.24) d and duration of lung X-ray shadow(6.16±0.63) d in the experimental group were significantly shorter than those in the control group(p<0.05).Our preliminary study showed that aerosol inhalation of budesonide and salbutamol for children with bronchopneumonia can effectively improve clinical symptoms and respiratory function, and enhance clinical index, and promote the recovery of children, which is worthy of promotion and application in practise.
引文
Chen M.,Lin X.J.,Zhang H.X.,and Fang M.,2017,Significance of procalcitonin and c-reactive protein in pneumonia with sepsis,Zhonghua Jizheng Yixue Zazhi(Chinese Journal of Emergency Medicine),26(7):807-810(陈淼,林晓军,张红璇,方明,2017,降钙素原和C反应蛋白在肺炎合并脓毒血症中的意义,中华急诊医学杂志,26(7):807-810)
Deng B.,Feng X.,Wang D.Y.,Zhang L.H.,and Cao L.,2016,Dynamic monitoring of plasma TNF-αand IL-10 and TGF-βlevels in patients with severe pneumonia,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),26(13):2942-2944(邓斌,冯霞,王定勇,张丽红,曹莉,2016,动态监测重症肺炎患者血浆中TNF-α与IL-10和TGF-β水平变化研究,中华医院感染学杂志,26(13):2942-2944)
Guo Y.,Shen C.,Li Q.J.,Sun L.,Jiao W.W.,Li J.Q.,Xu B.P.,and Sen A.D.,2017,Application value of mycoplasma pneumoniae polymerase chain reaction combined with probe detection in the diagnosis and drug resistance of mycoplasma pneumoniae pneumonia in children,Zhonghua Shiyong Erke Linchuang Zazhi(Chinese Journal of Applied Clinical Pedi atrics),32(16):1227-1230(郭琰,申晨,李勤静,孙琳,焦伟伟,李洁琼,徐保平,申阿东,2017,肺炎支原体聚合酶链反应结合探针检测在儿童肺炎支原体肺炎诊断及耐药中的应用价值,中华实用儿科临床杂志,32(16):1227-1230)
He B.,Diao W.Q.,and Shen N.,2017,The present situation of community acquired methicillin-resistant staphylococcus aureus pneumonia in China and the significance of gene diagnosis,Zhonghua Jiehu He Huxi Zazhi(Chinese Journal of Tuberculosis and Respiration),40(8):570-572(贺蓓,刁文琦,沈宁,2017,我国社区获得性耐甲氧西林金黄色葡萄球菌肺炎的现状及其基因诊断的意义,中华结核和呼吸杂志,40(8):570-572)
Lei Z.B.,Lei Z.D.,Liu L.F.,Li J.S.,and Hua C.Z.,2017,Effects of budesonide and salbutamol on children with bronchopneumonia and changes in serum IL-6 and TNF-αlevels were analyzed,Zhongguo Yikan(Chinese Journal of Medicine),52(4):74-76(雷泽宝,雷振东,刘丽芳,李军胜,华春珍,2017布地奈德与沙丁胺醇对支气管肺炎患儿的疗效及血清IL-6、TNF-α水平变化分析,中国医刊,52(4):74-76)
Liang Y.,Li J.H.,Luo Y.,Huang X.H.,and Zeng T.W.,2016Study on the clinical efficacy of budesonide aerosol inhalation in children with pneumonia,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),(4):928-929(梁粤,李敬衡,罗遥,黄小红,曾天文,2016,肺炎患儿应用布地奈德雾化吸入治疗的临床疗效研究,中华医院感染学杂志,(4):928-929)
Liu Y.P.,2017,Observation and nursing of aerosol inhalation budesonide in the treatment of children with measles and bronchopneumonia,Zhongguo Weisheng Biaozhun Guanli(China Health Standard Management),8(1):184-185(刘玉萍,2017,雾化吸入布地奈德治疗小儿麻疹合并支气管肺炎的观察护理,中国卫生标准管理,8(1):184-185)
Pang D.,Sun Q.Y.,and Yi L.,2016,Clinical analysis of common pathogens and drug resistance in children with bronchopneu monia,Guoji Jianyan Yixue Zazhi(International Journal of Laboratory Medicine),5(2):221-223(庞丹,孙巧英,伊乐2016,儿童支气管肺炎常见致病菌及耐药性临床分析,国际检验医学杂志,5(2):221-223)
Shi W.X.,Wu S.S.,Gong C.,Li A.H.,and Huang F.,2017,From2011 to 2015,the epidemiological characteristics and drug resistance of mycoplasma pneumoniae in the cases of community-acquired pneumonia in five sentinel hospitals in Bei jing,Zhonghua Yufang Yixue Zazhi(Chinese Journal of Preventive Medicine),51(9):832-836(石伟先,吴双胜,龚成李爱华,黄芳,2017,2011~2015年北京5家哨点医院社区获得性肺炎病例中肺炎支原体流行特征及耐药情况,中华预防医学杂志,51(9):832-836)
Tsukano K.,Suzuki K.,Shimamori T.,Sato A.,Kudo K.,Asano R.,Ajito T.,and Lakritz J.,2015,Profiles of serum amino acids to screen for catabolic and inflammation status in calves with Mycoplasma bronchopneumonia,J.Ve.Med.Sci.,77(1):67-73
Xiang H.,Chang M.,Wang Q.X.,and Lu H.Y.,2017,Etiological analysis of respiratory virus in 2108 children with bronchopneumonia in Zhenjiang area,Jiangsu Yiyao(Jiangsu Medical Journal),43(24):1787-1790(相虹,常明,王秋霞,卢红艳,2017,镇江地区2108例支气管肺炎患儿呼吸道病毒病原学分析,江苏医药,43(24):1787-1790)
Yang N.,Chen N.,and Sang Y.X.,2017,Clinical analysis of 49children with necrotizing pneumonia,Zhonghua Shiyong Erke Linchuang Zazhi(Chinese Journal of Applied Clinical Pediatrics),32(4):280-283(杨男,陈宁,尚云晓,2017,儿童坏死性肺炎49例临床分析,中华实用儿科临床杂志,32(4):280-283)
Zheng G.F.,Qiao X.H.,Lu S.L.,Bian Z.L.,and Geng R.,2017,Clinical efficacy of atomized inhalation of budesonide in the treatment of chronic cough after mycoplasma pneumoniae infection in children,Zhonghua Shiyong Erke Linchuang Zazhi(Chinese Journal of Applied Clinical Pediatrics),32(22):1705-1708(郑桂芬,乔晓红,卢双龙,卞竹利,耿锐,2017,雾化吸入布地奈德治疗儿童肺炎支原体感染后慢性咳嗽的临床疗效,中华实用儿科临床杂志,32(22):1705-1708)
Zellnitz S.,Narygina O.,Resch C.,Schroettner H.,and Urbanetza N.A.,2015,Crystallization speed of salbutamol as a function of relative humidity and temperature,Int.J.Pharm.,489(1/2):170-176
Zhou C.,Wang S.J.,Zhai Y.F.,Liu H.X.,and Chang J.,2016,Effects of budesonide aerosol inhalation on inflammatory cytokines and immune function in children with mycoplasma pneumonia,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),26(9):2136-2138(周成,王书举,翟玉峰,刘红霞,常静,2016,布地奈德雾化吸入对支原体肺炎患儿炎症因子与免疫功能的影响,中华医院感染学杂志,26(9):2136-2138)
Deng B.,Feng X.,Wang D.Y.,Zhang L.H.,and Cao L.,2016,Dynamic monitoring of plasma TNF-αand IL-10 and TGF-βlevels in patients with severe pneumonia,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),26(13):2942-2944(邓斌,冯霞,王定勇,张丽红,曹莉,2016,动态监测重症肺炎患者血浆中TNF-α与IL-10和TGF-β水平变化研究,中华医院感染学杂志,26(13):2942-2944)
Guo Y.,Shen C.,Li Q.J.,Sun L.,Jiao W.W.,Li J.Q.,Xu B.P.,and Sen A.D.,2017,Application value of mycoplasma pneumoniae polymerase chain reaction combined with probe detection in the diagnosis and drug resistance of mycoplasma pneumoniae pneumonia in children,Zhonghua Shiyong Erke Linchuang Zazhi(Chinese Journal of Applied Clinical Pedi atrics),32(16):1227-1230(郭琰,申晨,李勤静,孙琳,焦伟伟,李洁琼,徐保平,申阿东,2017,肺炎支原体聚合酶链反应结合探针检测在儿童肺炎支原体肺炎诊断及耐药中的应用价值,中华实用儿科临床杂志,32(16):1227-1230)
He B.,Diao W.Q.,and Shen N.,2017,The present situation of community acquired methicillin-resistant staphylococcus aureus pneumonia in China and the significance of gene diagnosis,Zhonghua Jiehu He Huxi Zazhi(Chinese Journal of Tuberculosis and Respiration),40(8):570-572(贺蓓,刁文琦,沈宁,2017,我国社区获得性耐甲氧西林金黄色葡萄球菌肺炎的现状及其基因诊断的意义,中华结核和呼吸杂志,40(8):570-572)
Lei Z.B.,Lei Z.D.,Liu L.F.,Li J.S.,and Hua C.Z.,2017,Effects of budesonide and salbutamol on children with bronchopneumonia and changes in serum IL-6 and TNF-αlevels were analyzed,Zhongguo Yikan(Chinese Journal of Medicine),52(4):74-76(雷泽宝,雷振东,刘丽芳,李军胜,华春珍,2017布地奈德与沙丁胺醇对支气管肺炎患儿的疗效及血清IL-6、TNF-α水平变化分析,中国医刊,52(4):74-76)
Liang Y.,Li J.H.,Luo Y.,Huang X.H.,and Zeng T.W.,2016Study on the clinical efficacy of budesonide aerosol inhalation in children with pneumonia,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),(4):928-929(梁粤,李敬衡,罗遥,黄小红,曾天文,2016,肺炎患儿应用布地奈德雾化吸入治疗的临床疗效研究,中华医院感染学杂志,(4):928-929)
Liu Y.P.,2017,Observation and nursing of aerosol inhalation budesonide in the treatment of children with measles and bronchopneumonia,Zhongguo Weisheng Biaozhun Guanli(China Health Standard Management),8(1):184-185(刘玉萍,2017,雾化吸入布地奈德治疗小儿麻疹合并支气管肺炎的观察护理,中国卫生标准管理,8(1):184-185)
Pang D.,Sun Q.Y.,and Yi L.,2016,Clinical analysis of common pathogens and drug resistance in children with bronchopneu monia,Guoji Jianyan Yixue Zazhi(International Journal of Laboratory Medicine),5(2):221-223(庞丹,孙巧英,伊乐2016,儿童支气管肺炎常见致病菌及耐药性临床分析,国际检验医学杂志,5(2):221-223)
Shi W.X.,Wu S.S.,Gong C.,Li A.H.,and Huang F.,2017,From2011 to 2015,the epidemiological characteristics and drug resistance of mycoplasma pneumoniae in the cases of community-acquired pneumonia in five sentinel hospitals in Bei jing,Zhonghua Yufang Yixue Zazhi(Chinese Journal of Preventive Medicine),51(9):832-836(石伟先,吴双胜,龚成李爱华,黄芳,2017,2011~2015年北京5家哨点医院社区获得性肺炎病例中肺炎支原体流行特征及耐药情况,中华预防医学杂志,51(9):832-836)
Tsukano K.,Suzuki K.,Shimamori T.,Sato A.,Kudo K.,Asano R.,Ajito T.,and Lakritz J.,2015,Profiles of serum amino acids to screen for catabolic and inflammation status in calves with Mycoplasma bronchopneumonia,J.Ve.Med.Sci.,77(1):67-73
Xiang H.,Chang M.,Wang Q.X.,and Lu H.Y.,2017,Etiological analysis of respiratory virus in 2108 children with bronchopneumonia in Zhenjiang area,Jiangsu Yiyao(Jiangsu Medical Journal),43(24):1787-1790(相虹,常明,王秋霞,卢红艳,2017,镇江地区2108例支气管肺炎患儿呼吸道病毒病原学分析,江苏医药,43(24):1787-1790)
Yang N.,Chen N.,and Sang Y.X.,2017,Clinical analysis of 49children with necrotizing pneumonia,Zhonghua Shiyong Erke Linchuang Zazhi(Chinese Journal of Applied Clinical Pediatrics),32(4):280-283(杨男,陈宁,尚云晓,2017,儿童坏死性肺炎49例临床分析,中华实用儿科临床杂志,32(4):280-283)
Zheng G.F.,Qiao X.H.,Lu S.L.,Bian Z.L.,and Geng R.,2017,Clinical efficacy of atomized inhalation of budesonide in the treatment of chronic cough after mycoplasma pneumoniae infection in children,Zhonghua Shiyong Erke Linchuang Zazhi(Chinese Journal of Applied Clinical Pediatrics),32(22):1705-1708(郑桂芬,乔晓红,卢双龙,卞竹利,耿锐,2017,雾化吸入布地奈德治疗儿童肺炎支原体感染后慢性咳嗽的临床疗效,中华实用儿科临床杂志,32(22):1705-1708)
Zellnitz S.,Narygina O.,Resch C.,Schroettner H.,and Urbanetza N.A.,2015,Crystallization speed of salbutamol as a function of relative humidity and temperature,Int.J.Pharm.,489(1/2):170-176
Zhou C.,Wang S.J.,Zhai Y.F.,Liu H.X.,and Chang J.,2016,Effects of budesonide aerosol inhalation on inflammatory cytokines and immune function in children with mycoplasma pneumonia,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),26(9):2136-2138(周成,王书举,翟玉峰,刘红霞,常静,2016,布地奈德雾化吸入对支原体肺炎患儿炎症因子与免疫功能的影响,中华医院感染学杂志,26(9):2136-2138)