阿法骨化醇辅助治疗小儿毛细支气管炎的临床观察  

Clinical Observation of Alfacalcidol in Adjuvant Treatment of Bronchiolitis in Children

作　　者：陈金妮[1] 李大伟[2] 冯小伟[1] 

机构地区：[1]海南省人民医院儿科,海口570000 [2]海南医学院附属医院内分泌科,海口570000

出　　处：《中国药房》2017年第6期756-758,共3页China Pharmacy

摘　　要：目的:观察阿法骨化醇辅助治疗小儿毛细支气管炎的临床疗效和安全性。方法:回顾性分析156例毛细支气管炎患儿资料,按照用药不同分为观察组(78例)和对照组(78例)。所有患儿入院后均接受吸氧、平喘、抗病毒等常规治疗,在此基础上对照组患儿给予布地奈德混悬液0.5~1.0 mg+沙丁胺醇气雾剂0.25 m L,雾化吸入,bid,每次吸入10 min,连续治疗7 d。观察组患儿在对照组治疗基础上加服阿法骨化醇软胶囊0.010~0.015μg/(kg·d),每周3次,连续治疗3个月。观察并比较两组患儿临床疗效,临床症状及体征改善时间,治疗前后血清维生素D[25-(OH)D_3]、血清瘦素(LEP)、免疫球蛋白(Ig)A、Ig G、Ig M、Ig E水平和不良反应发生情况。结果:治疗7 d后观察组患儿总有效率显著高于对照组,咳嗽、喘息缓解时间,哮鸣音及湿啰音消失时间显著短于对照组,差异均有统计学意义(P<0.05);治疗3个月后,两组患儿25-(OH)D_3、Ig A、Ig G水平显著高于同组治疗前,且观察组显著高于对照组;两组患儿LEP、Ig E水平显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组患儿治疗前后Ig M水平比较差异无统计学意义(P>0.05)。两组患儿治疗过程中均未见明显药物相关的不良反应发生。结论:在常规治疗基础上,阿法骨化醇辅助治疗小儿毛细支气管炎疗效较好,可以明显增强患儿免疫功能,降低血清LEP水平,进而缩短患儿临床症状及体征缓解时间,且不增加不良反应的发生,安全性较好。OBJECTIVE：To explore the clinical efficacy and safety of alfacalcidol in the adjuvant treatment of bronchiolitis in children. METHODS：Data of 156 children with bronchiolitis were retrospectively collected and divided into observation group（78cases） and control group（78 cases） by different medication. All children received oxygen inhalation,relieving asthma,antiviral and other conventional treatment,then control group inhaled Budesonide suspension 0.5-1.0 mg ＋ Salbutamol aerosol 0.25 m L for atomization,bid,10 min every times,7-d was a course. Observation group additionally given Alfacalcidol soft capsule 0.010-0.015μg/（kg·d）,3 times a week,3-month was a course. They were treated for 3 months. Clinical efficacy,improvement time of clinical symptoms and signs,levels of 25-（OH）D_3and serum LEP,Ig A,Ig G,Ig M and Ig E before and after treatment,and the incidence of adverse reactions in 2 groups were observed and compared. RESULTS：The total effective rate in observation group was significantly higher than control group,improvement time of cough,asthma,wheezing and moist rale were significantly shorter than control group with statistical significansce（P〈0.05） after 7-d treatment;after 3-month treatment,25-（OH）D_3,Ig A and Ig G levels were significantly higher than before,and observation group was higher than control group,LEP and Ig E levels were significantly lower than before,and observation group was lower than control group,with statistical significances（P〈0.05）. There was no significantly difference of the level of Ig M in 2 groups before and after treatment. And there were no severe adverse reactions in 2groups. CONCLUSIONS：Based on conventional treatment,alfacalcidol shows good efficacy in the adjuvant treatment of bronchiolitis in children,which can obviously enhance immune function,reduce serum LEP level,then shorten remission time of clinical symptoms and signs,with less adverse reactions and good safety.

关 键 词：维生素D 阿法骨化醇 毛细支气管炎 咳喘 免疫功能 不良反应 

分 类 号：R720.5[医药卫生—儿科]