沙丁胺醇、布地奈德辅助雾化吸入治疗小儿哮喘合并呼吸道病毒感染的疗效及预后观察  

Curative effect and prognosis of salbutamol and budesonide-assisted nebulization on children with asthma and respiratory virus infection

作　　者：李涛[1] 张海波 唐静[1] 张雪莲[1] 刘振华 LI Tao;ZHANG Hai-bo;TANG Jing(Department of Pediatrics,Chengde City Central Hospital,Chengde Hebei 067000;Chengde Women's and Children's Health Hospital,Chengde Hebei 067000,China)

机构地区：[1]承德市中心医院儿科,河北承德067000 [2]承德市妇幼保健院,河北承德067000

出　　处：《临床和实验医学杂志》2020年第19期2070-2074,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省科技计划项目(编号:20132014)。

摘　　要：目的探究小儿哮喘合并呼吸道病毒感染采用沙丁胺醇、布地奈德辅助雾化吸入治疗疗效以及对预后的影响。方法回顾性选取承德市中心医院2018年6月至2019年6月收治105例哮喘合并呼吸道病毒感染患儿相关资料,依据患儿用药方案分为对照组以及联合组,分别51例和54例,对照组接受常规治疗加沙丁胺醇雾化吸入治疗,联合组在对照组基础上接受布地奈德治疗。比较两组患儿治疗后疗效、相关症状改善时间、治疗前后肺功能[第1秒用力呼气量(FEV1)、呼气流速峰值(PEFR)以及用力肺活量(FVC)]、免疫功能情况和预后情况。结果联合组患儿治疗后总有效率98.15%,显著高于对照组患儿84.31%,(P<0.05);联合组患儿哮鸣音消失、气促、喘憋、发热、咳嗽[(4.46±0.79)、(3.04±1.06)、(3.42±0.65)、(2.84±0.59)、(3.41±0.75)d]等症状改善时间均显著低于对照组[(9.13±1.08)、(6.22±1.30)、(5.29±0.88)、(3.46±0.72)、(7.52±0.84)d](P<0.05);两组患儿治疗后肺功能如FEV1、PEFR、FVC等指标显著改善(P<0.05),治疗后联合组患儿FEV1、PEFR、FVC等肺功能指标显著高于对照组[(2.26±0.64)L vs.(3.54±0.79)L、(2.34±0.75)L/min vs.(3.59±1.07)L/min、(2.25±0.64)L vs.(3.37±0.65)L](P<0.05);两组患儿治疗后免疫蛋白如IgA、IgG以及IgM,T淋巴细胞如CD4^+、CD8^+、CD4^+/CD8^+显著高于治疗前,且治疗后联合组患儿上述免疫功能指标改善优于对照组[(1.64±0.48)g/L vs.(1.08±0.42)g/L、(1.73±0.65)g/L vs.(1.32±0.33)g/L、(13.65±2.17)g/L vs.(10.57±2.23)g/L、(46.78±5.22)%vs.(40.69±5.79)%、(1.72±0.48)vs.(1.53±0.43)],差异具有统计学意义(P<0.05);联合组患儿随访期间上下呼吸道感染次数以及哮喘发作次数少于对照组[(3.41±0.57)vs.(4.52±0.66)、(1.18±0.31)vs.(2.06±0.43)、(3.57±1.13)vs.(6.16±1.24)],差异有统计学意义(P<0.05)。结论小儿哮喘合并呼吸道病毒感染采用沙丁胺醇、布地奈德辅助雾化吸入可以通过改善患Objective To explore curative effect of salbutamol and budesonide-assisted nebulization on children with asthma and respiratory virus infection(RVI)and influences on prognosis.Methods During the period from June 2018 to June 2019,clinical data of 105 patients with asthma and RVI who were admitted to the hospital were collected.According to different medication regimens,they were divided into control group(51 cases)and combination group(54 cases).The control group underwent routine treatment and salbutamol nebulization,while combination group was treated with budesonide on basis of control group.The curative effect after treatment,improvement time of related symptoms,lung function,immune function and prognosis before and after treatment were compared between the two groups.Results After treatment,total response rate in combination group was significantly higher than that in control group(98.15%vs.84.31%)(P<0.05).The wheezing rale,remission time of polypnea,wheezing,fever and cough relief time in combination group[(4.46±0.79),(3.04±1.06),(3.42±0.65),(2.84±0.59),(3.41±0.75)d]was significantly shorter than that in control group[(9.13±1.08),(6.22±1.30),(5.29±0.88),(3.46±0.72),(7.52±0.84)d](P<0.05).After treatment,lung function indexes(FEV1,PEFR,FVC)in both groups were significantly improved.Besides,FEV1,PEFR and FVC of the combination group were significantly higher than those of the control group[(2.26±0.64)L vs.(3.54±0.79)L,(2.34±0.75)L/min vs.(3.59±1.07)L/min,(2.25±0.64)L vs.(3.37±0.65)L](P<0.05).Immune proteins(IgA,IgG,IgM)and T lymphocytes(CD4^+,CD8^+,CD4^+/CD8^+)in both groups were significantly increased.Besides,the improvement was better in combination group than control group[(1.64±0.48)g/L vs.(1.08±0.42)g/L,(1.73±0.65)g/L vs.(1.32±0.33)g/L,(13.65±2.17)g/Lvs.(10.57±2.23)g/L,(46.78±5.22)%vs.(40.69±5.79)%,(1.72±0.48)vs.(1.53±0.43)](P<0.05).The times of respiratory infection and times of asthma attacks in combination group were less than those in control group during follow-up[(3.41±0.

关 键 词：小儿哮喘 沙丁胺醇 布地奈德雾化吸入 呼吸道病毒感染 疗效 

分 类 号：R725.6[医药卫生—儿科]