吸入β2肾上腺素能受体激动剂联合抗胆碱类药物治疗对喘息性支气管炎婴儿肺功能的影响  

Study on Pulmonary Function Change in Infants with Asthmatic Bronchitis Treated with β2 Adenoreceptor Agonist and Ipratropium Bromide Inhalation.

作　　者：黄旭强[1] 江文辉[1] 邓力[1] 温惠虹[1] 何春卉[1] 

机构地区：[1]广州市儿童医院,510120

出　　处：《国际儿科学杂志》2007年第3期160-162,共3页International Journal of Pediatrics

基　　金：广州市医药卫生科研项目（96-11）

摘　　要：目的了解吸入β2肾上腺素能受体激动剂联合抗胆碱类药物治疗对喘息性支气管炎婴儿肺功能的影响。方法23例5个月-1岁的喘息性支气管炎患儿，在吸入硫酸沙丁胺醇与异丙托溴铵复合溶液前和吸入后30、60及120min各行1次潮气呼吸流速．容量环（TBFV环）检查，同时以20名健康婴儿作为对照，并进行肺功能各项指标比较，包括TBFV环的形态。反映小气道功能的敏感指标：到达潮气呼气峰流速时的呼气量，潮气量（%V-PFV），呼出75％潮气量时的呼气流速，潮气呼气峰流速（25/PF），潮气呼气峰流速（PTEF）；反映大气道功能的指标：潮气呼气中期流速，潮气吸气中期流速（ME/MI），反映潮气呼吸状态下通气功能的指标：包括呼吸频率和每千克体重潮气量（TV/kg）。结果喘息性支气管炎患儿TBFV环中呼气降支凹陷，呼气峰流速前移，治疗前与吸入药物后30、60及120min患儿的TBFV环形态无明显变化；治疗前与吸入药物后30、60及120min呼吸频率、％V-PF、2．5／PF、ME／MI、PTEF和TV/kg的差异均无统计学意义（P〉0．05）。结论吸入硫酸沙丁胺醇与异丙托溴铵复合溶液后，喘息性支气管炎患儿大小气道阻力及通气功能的改善并不明显，提示β2肾上腺素能受体激动剂联合抗胆碱类药物吸入治疗对喘息性支气管炎患儿的肺功能无显著改善。Objective To explore the pulmonary function change in infants with asthmatic bronchitis treated with salbutamol and ipratropium bromide inhalation. Methods Tidal breath flow volume circle （TBFV） tests were performed respectively in 23 infants with asthmatic bronchitis before and after 30 minutes,60 minutes and 120 minutes being treated with salbutamol and ipratropium bromide inhalation and then indexes of pulmonary function including the shape of TBFV circle, the parameters reflecting small airway function such as the expiratory volume/tidal volume at the point of peak tidal expiratory flow（ % V-PF）, ratio of expiratory flow at 75% tidal volume to peak tidal expiratory flow（25/PF）, peak tidal expiratory flow（PTEF）, the parameters reflecting large airway function such as the ratio of midtidal expiratory flow to mid-tidal inspiratory flow（ME/MI） and the parameters reflecting ventilation function under tidal respiratory condition such as respiratory rate（RR） and tidal volume per kilogram （TV/kg） were compared. Results The TBFV circle shape of infants with asthmatic bronchitis showed an umbilication at the descending part of expiratory and the peak expiratory flow emerged earlier than normal. The shape of TBFV circle had no significant change before and after 30 minutes,60 minutes and 120 minutes being treated with salbutamol and ipratropium bromide inhalation. There were no significant difference in RR, %V-PF,25/PF, ME/MI, PTEF and TV/kg before and after 30 minutes, 60 minutes and 120 minutes treated with salbutamol and ipratropium bromide inhalation （ P 〉 0.05 ）. Conclusions Small and large airway resistance and ventilation function of infants with asthmatic bronchitis had no significant improvement after being treated with salbutamol and ipratropium bromide inhalation, which suggests that adenoreceptor agonist and ipratropium bromide inhalation has no significant effect on improving the pulmonary function of infants with asthmatic bronchitis.

关 键 词：沙丁胺醇 异丙托铵 支气管炎 

分 类 号：R72[医药卫生—儿科]