红霉素、布地奈德联合重组人干扰素1b治疗小儿闭塞性细支气管炎的临床研究  

Clinical study of Erythromycin and Budenide combined with recombinant human interferon α1b in the treatment of children with bronchiolitis obliteratus

作　　者：丁淑玉[1] 李亚伟[1] 杨新丽[1] 闫海燕 杨慧卫 尚庚 潘晓[1] 张清[1] DING Shuyu;LI Yawei;YANG Xinli;YAN Haiyan;YANG Huiwei;SHANG Geng;PAN Xiao;ZHANG Qing(Department of Paediatrics, the Second Center Hospital of Baoding City, Hebei Province, Zhuozhou 072750, China;Department of Respiration, the Second Center Hospital of Baoding City, Hebei Province, Zhuozhou 072750, China;Department of Paediatrics, Zhuozhou Changhe Children′s Hospital of Beijing Children′s Hospital Medical Group, Hebei Province, Zhuozhou 072750, China)

机构地区：[1]河北省保定市第二中心医院儿科,河北涿州072750 [2]河北省保定市第二中心医院呼吸科,河北涿州072750 [3]北京儿童医院医疗集团涿州长和儿童医院儿科,河北涿州072750

出　　处：《中国医药导报》2019年第12期119-122,共4页China Medical Herald

基　　金：河北省卫生计生委医学科学研究重点课题(20171063)

摘　　要：目的探讨红霉素、布地奈德联合重组人干扰素α1b治疗小儿闭塞性细支气管炎(BO)的临床效果及安全性。方法选取2012年1月～2016年6月河北省保定市第二中心医院收治的82例BO患儿,按照随机数字表法将其分为对照组(n=41)和观察组(n=41)。对照组给予小剂量红霉素联合布地奈德治疗,观察组给予小剂量红霉素、布地奈德联合重组人干扰素α1b治疗,两组均治疗7 d。观察并比较两组临床疗效、喘憋消失时间、咳嗽消失时间、气促消失时间、肺部啰音消失时间、治疗前后呼吸频率(RR)、潮气量(VT)、呼吸时间比(Ti/Te)、血清γ干扰素(IFN-γ)、白细胞介素-4(IL-4)水平及不良反应情况。结果观察组的临床总有效率明显高于对照组,差异有统计学意义(P <0.05)。观察组的喘憋消失时间、咳嗽消失时间、气促消失时间及肺部啰音消失时间均明显短于对照组,差异有统计学意义(P <0.05)。两组治疗后RR、Ti/Te、血清IFN-γ水平较治疗前降低,VT、血清IL-4水平较治疗前升高,且观察组治疗后RR、VT、Ti/Te及血清IFN-γ、IL-4水平的改善幅度大于对照组治疗后(P <0.05)。两组治疗过程中均未出现严重的不良反应。结论红霉素、布地奈德联合重组人干扰素α1b治疗小儿BO的临床效果显著,能够明显改善临床症状,改善肺功能和炎性反应,且安全性较好。Objective To investigate the clinical effect and safety of Erythromycin and Budesonide combined with recombinant human interferonα1 b in the treatment of pediatric bronchiolitis obliteratus(BO).Methods From January2012 to June 2016,82 children with BO in the Second Center Hospital of Baoding were selected,and they were divided into the control group(n=41)and observation group(n=41)according to the random number table method.The control group were given low dose of Erythromycin combined with Budesonide,and the observation group was treated with low dose of Erythromycin combined with Budesonide and recombinant human interferonα1 b,the two groups were treated for 7 days.The clinical efficacy,wheezing and holding disappeared time,cough disappeared time,shortness of breath disappeared time,lung rale disappeared time,respiratory rate(RR),tidal volume(VT),respiratory time ratio(Ti/Te),serum gamma interferon(IFN-γ),interleukin-4(IL-4)levels and adverse reactions were observed and compared between the two groups.Results The total clinical effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The disappearance times of wheezing and holding,cough,shortness of breath and lung rale in the observation group were significantly shorter than that in the control group(P<0.05).After treatment,the RR,Ti/Te and serum IFN-γlevels in the two groups were lower than that before treatment,and the VT and serum IL-4 levels were higher than that before treatment.The RR,VT,Ti/Te and serum IFN-γand IL-4 levels in the observation group were significantly improved than those in the control group(P<0.05).No serious adverse reactions occurred during the treatment in both groups.Conclusion Erythromycin,Budesonide combined with recombinant human interferonα1 b in the treatment of pediatric BO has a significant clinical effect,can significantly improve the clinical symptoms,improve pulmonary function and inflammatory response,and better safety.

关 键 词：闭塞性细支气管炎 红霉素 布地奈德 重组人干扰素Α1B 效果 

分 类 号：R725.6[医药卫生—儿科]