合并结核感染的支气管哮喘儿童临床治疗研究  

Clinical analysis of the efficacy of 32 cases of the asthma children with tuberculosis infection

作　　者：罗厚江[1,2] 潘家华[1] 倪陈[1] 计明红[1] 陈云龙[1] 王珅 陈伟[1] 

机构地区：[1]安徽医科大学附属省立医院儿科,合肥230001 [2]蚌埠医学院第二附属医院儿科,233000

出　　处：《安徽医学》2010年第5期442-445,共4页Anhui Medical Journal

摘　　要：目的观察结核感染对儿童支气管哮喘疗效的影响,为人工结核感染辅助治疗儿童哮喘提供科学依据。方法 32例有结核感染的支气管哮喘患儿作为观察组,27例无结核感染的哮喘患儿为对照组,两组均给予布地耐德福莫特罗粉吸入剂吸入治疗,剂量为80/4.5μg,早晚各吸1次。有哮喘急性发作时,加用沙丁胺醇(万托林)气雾剂,病情较重时加用强的松口服。观察组另外加用抗结核药物治疗。比较两组治疗效果。结果治疗3个月、6个月后万托林、强的松平均个人使用剂量观察组小于对照组,差异有统计学意义(P<0.05);呼吸道感染次数、急诊次数3个月后两组差异无统计学意义(P>0.05),6个月后,观察组明显少于对照组,差异有统计学意义(P<0.05),住院次数两组差异无统计学意义(P>0.05);两组用力肺活量(FVC)、一秒用力呼气容积(FEV1)、一秒率(FEV1/FVC)、用力呼气瞬间流速FEF25、FEF50、FEF753个月后均有增加,但差异无统计学意义(P>0.05),6个月后观察组增加明显好于对照组,差异有统计学意义(P<0.05)。结论结核感染可以增加支气管哮喘患儿吸入糖皮质激素治疗的疗效,为人工结核感染辅助治疗儿童支气管哮喘提供科学依据。Objective The inrestigotior of impact of tuberculosis （TB） infection on the efficacy of inhaled glucoeorticoids on children has provided the scientific evidence of TB infection for adjuvant treatment of asthma in children. Methods 32 cases of asthma children who concurrently infected TB were enrolled as the observation group, control group consisted of 27 cases of asthma children who tuberculin purified protein derivative （TB - PPD） skin test are negative. All the asthma children were treated with Budesonide and Formoterol Fumarate Powder for Inhalation, using Ventolin aerosol when acute asthma attack, if the condition was serious, prednisone can be used . Meanwhile observation group was treated with anti - TB drugs additionally. Results after three months and six months, Ventolin and Prednisone are at lower dosages in the observation group, the difference was significant （P 〈 0.05） ;frequency of respiratory tract infection and emergency in three months are no significant difference between the two groups （ P 〉 0.05 ） , after six months , the difference was significant （ P 〈 0.05 ） , frequency of hospitalization was no significant difference between two groups （P 〉 0. 05 ） ;after three months, the FVC, FEV1 , FEV1/FVC, FEF25 ,FEF50 and FEF75 have increased in observation groups, compared to the control group was no significant difference （P 〉 0.05 ）, after treatment for six months, the difference was significant （ P 〈 0.05）. Conclusion the clinical efficacy of ICS on children with asthma complicated TB infection is better than those who has no TB infection. The method of purposive TB infection for adjuvant treatment of asthma in children is credible.

关 键 词：结核感染 支气管哮喘 吸入型糖皮质激素 儿童 

分 类 号：R725.6[医药卫生—儿科]