山莨菪碱联合布地奈德对肺炎感染患儿肺功能和免疫功能及细胞因子的影响  

Effects of anisodamine combined with budesonide on pulmonary function,immune function and cytokines in children with pneumonia infection

作　　者：黎海燕[1] 扶红根 丁国标[1] 徐丹丹 陈文娟[1] LI Hai-yan;FU Hong-gen;DING Guo-biao;XU Dan-dan;CHEN Wen-juan(Jiujiang Maternal and Child Health Hospital,Jiujiang,Jiangxi 332000,China)

机构地区：[1]九江市妇幼保健院儿内科,江西九江332000

出　　处：《中华医院感染学杂志》2020年第20期3174-3179,共6页Chinese Journal of Nosocomiology

基　　金：江西省卫生计生委科技计划基金资助项目(20191717)。

摘　　要：目的分析探究山莨菪碱联合布地奈德治疗对肺炎感染患儿肺功能、T淋巴细胞亚群、白细胞介素-6(IL-6)、降钙素原(PCT)的影响。方法随机选取2018年12月-2019年12月九江市妇幼保健院儿内科收治的肺炎感染患儿202例为研究对象,随机将其分为对照组100例(基础对症及布地奈德混悬液雾化吸入治疗)与研究组102例(在对照组基础上联合山莨菪碱治疗),疗程均为14d。记录两组患儿各项症状消失及体征恢复时间,对比分析治疗前后肺功能相关指标[肺活量FVC、最大深吸气后做最大呼气(FEV1)、最大呼气流量(PEF)、最大呼气流速(PEF25),检测T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)]、血清炎症因子IL-6、IL-8、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和PCT,并判定临床疗效。结果研究组患儿退热、咳嗽消失、肺部湿罗音消失时间以及氧饱和度恢复、白细胞恢复正常、胸片吸收时间分别为(2.33±1.14)d、(4.12±1.21)d、(5.03±1.42)d及(3.84±0.62)d、(4.78±1.45)d、(6.02±1.25)d均短于对照组(P<0.001)。治疗前,两组患儿肺功能相关指标比较差异均无统计学意义;治疗后,研究组患儿FVC、FEV1、PEF、PEF25水平均较治疗前明显改善(P<0.05),且以上指标分别为(76.95±8.22)%、(1.91±0.42)L、(2.69±0.84)L/s、(1.43±0.35)L/s高于对照组(P<0.001)。治疗后两组CD3^+、CD4^+、CD4^+/CD8^+水平均较治疗前提高,CD8^+水平较治疗前降低(P<0.05);治疗后研究组T淋巴细胞亚群各指标改善情况明显优于对照组(P<0.05)。治疗前,两组血清炎症因子处于较高水平,组间差异无统计学意义;治疗后,两组IL-6、IL-8、TNF-α、CRP、PCT水平均出现不同程度下降,对照组各指标分别为(30.26±9.74)ng/L、(14.86±6.13)ng/L、(36.34±9.73)ng/L、(12.84±5.34)mg/L、(0.65±0.26)μg/L高于研究组(P<0.05)。研究组疗效优于对照组(P=0.007)。结论在对症治疗基础上应用山莨菪碱联合布地奈德可显著缩�OBJECTIVE To analyze the effect of anisodamine combined with budesonide treatment on pulmonary function,T lymphocyte subsets,interleukin-6(IL-6),procalcitonin(PCT)in children with pneumonia infection.METHODS Totally 202children with pneumonia infection admitted to the Department of Pediatrics of Jiujiang Maternal and Child Health Hospital from Dec.2018to Dec.2019were selected as research subjects,randomly selected and randomly divided into 100cases in control group(basic symptomatic and budesonide suspension atomization inhalation treatment)and 102cases in study group(combined with anisodamine treatment on the basis of the control group),with the course of treatment for 14days.The time of symptom disappearance and physical signs recovery in the two groups of children were recorded,and the relevant indicators of lung function before and after treatment(including FVC,FEV1,PEF,PEF25)were compared,and T lymphocyte subsets(CD3^+,CD4^+,CD8^+,and CD4^+/CD8^+,respectively),serum inflammatory factors IL-6,IL-8,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and PCT were detected,and the clinical efficacy was determined.RESULTS The time of fever and cough disappearance,lung moist rales disappearance,oxygen saturation recovery,white blood cell counts recovery and chest X-ray absorption in the study group were(2.33±1.14)d,(4.12±1.21)d,(5.03±1.42)d,(3.84±0.62)d,(4.78±1.45)d and(6.02±1.25)d,respectively,all significently shorter than those in the control group(P<0.05).Before treatment,there was no significant difference in lung function-related indicators between the two groups of children.After treatment,the levels of FVC,FEV1,PEF and PEF25in the study group were significantly improved compared with those before treatment(P<0.05),and the above indexes were(70.23±7.83)%,(1.56±0.36)L,(2.33±0.65)L/s,and(1.24±0.30)L/s,respectively,significantly higher than those in the control group(P<0.05).The levels of CD3^+,CD4^+,and CD4^+/CD8^+in the two groups after treatment were significently higher than those before trea

关 键 词：山莨菪碱 布地奈德 小儿肺炎 肺功能 T淋巴细胞 血清炎症因子 

分 类 号：R563.1[医药卫生—呼吸系统]