布地奈德联合异丙托溴铵雾化吸入治疗婴幼儿病毒性肺炎的疗效及对免疫球蛋白、SAA、CRP、PCT水平的影响  

Efficacy of budesonide combined with ipratropium bromide inhalation in the treatment of infant viral pneumoniaand its influence on the immunoglobulin, amyloid A, C-reactive protein and procalcitonin levels

作　　者：廖加鑫 苏丽珊 林伟淳 LIAO Jia-xin;SU Li-shan;LIN Wei-chun(Department of Pediatrics,Shantou Second People's Hospital,Shantou 515000,Guangdong,CHINA)

机构地区：[1]汕头市第二人民医院儿科,广东汕头515000

出　　处：《海南医学》2021年第9期1151-1154,共4页Hainan Medical Journal

摘　　要：目的观察布地奈德联合异丙托溴铵雾化吸入治疗婴幼儿病毒性肺炎的疗效,并探讨其对患儿免疫球蛋白、淀粉样蛋白A(SAA)、C反应蛋白(CRP)和降钙素原(PCT)水平的影响。方法回顾性分析2019年7月至2020年10月汕头市第二人民医院儿科收治的53例病毒性肺炎患儿的临床资料。按照治疗方式不同分组,其中25例在常规治疗措施上使用重组人干扰素α1b治疗者纳入对照组,28例在对照组基础上联合布地奈德和异丙托溴铵雾化吸入治疗者纳入观察组,均连续治疗7 d。比较两组患儿治疗后的临床疗效、症状消失时间及治疗前、治疗后的血清免疫球蛋白(Ig)G、IgA、IgM、IgE、SAA、CRP、PCT水平及不良反应情况。结果治疗后,观察组患儿的治疗总有效率为92.86%,明显高于对照组的72.00%,差异有统计学意义(P<0.05);治疗后,观察组患儿的退热时间、呼吸困难、咳嗽及肺啰音消失时间分别为(2.89±0.40)d、(2.18±0.33)d、(4.59±0.67)d、(5.85±0.60)d,明显短于对照组的(3.47±0.49)d、(2.79±0.42)d、(5.82±0.60)d、(6.72±0.75)d,差异均有统计学意义(P<0.05);治疗后,观察组患儿的血清IgG、IgA、IgM水平分别为(8.03±1.19)g/L、(0.94±0.14)g/L、(1.46±0.20)g/L,明显高于对照组的(7.15±1.20)g/L、(0.81±0.10)g/L、(1.20±0.15)g/L,血清IgE、SAA、CRP、PCT水平分别为(0.09±0.02)g/L、(23.45±3.02)mg/L、(3.61±0.45)mg/L、(0.11±0.02)μg/L,明显低于对照组的(0.13±0.03)g/L、(40.18±3.47)mg/L、(6.74±0.70)mg/L、(0.17±0.03)μg/L,差异均有统计学意义(P<0.05);观察组和对照组患儿的不良反应总发生率分别为10.71%和8.00%,差异无统计学意义(P>0.05)。结论布地奈德联合异丙托溴铵雾化吸入治疗婴幼儿病毒性肺炎可有效改善患儿血清免疫球蛋白、SAA、CRP、PCT的表达水平,临床治疗效果显著,值得应用推广。Objective To observe the efficacy of budesonide combined with ipratropium bromide aerosol inhalation in the treatment of infantile viral pneumonia,and to explore its influence on the levels of immunoglobulin,amyloid A(SAA),C-reactive protein(CRP)and procalcitonin(PCT)levels.Methods The clinical data of 53 children with viral pneumonia admitted to the Department of Pediatrics,Shantou Second People's Hospital from July 2019 to October 2020 were retrospectively analyzed.According to different treatment methods,25 patients who were treated with recombinant human interferonα1b on the basis of conventional treatment measures were included in the control group,and 28 patients who were treated with budesonide combined with ipratropium bromide aerosol inhalation on the basis of the control group were included in the observation group,all of which were treated for 7 days continuously.The clinical efficacy 7 d after treatment,symptom disappearance time and the serum immunoglobulin(Ig)G,IgA,IgM,IgE,SAA,CRP and PCT levels before treatment and 7 d after treatment and the incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate in the observation group was 92.86%,which was significantly higher than 72.00%of the control group(P<0.05);the fever abatement time and the dyspnea,cough and pulmonary rales disappearance time in the observation group were(2.89±0.40)d,(2.18±0.33)d,(4.59±0.67)d,(5.85±0.60)d,respectively,which were significantly shorter than corresponding(3.47±0.49)d,(2.79±0.42)d,(5.82±0.60)d,(6.72±0.75)d(all P<0.05);the serum IgG,IgA and IgM levels in the observation group were(8.03±1.19)g/L,(0.94±0.14)g/L,(1.46±0.20)g/L,respectively,which were significantly higher than corresponding(7.15±1.20)g/L,(0.81±0.10)g/L,(1.20±0.15)g/L of the control group(all P<0.05);the serum IgE,SAA,CRP,PCT levels were(0.09±0.02)g/L,(23.45±3.02)mg/L,(3.61±0.45)mg/L,(0.11±0.02)μg/L,respectively,which were significantly lower than corresponding(0.13±0.03)g/L,(40.18±

关 键 词：婴幼儿 病毒性肺炎 布地奈德 异丙托溴铵 免疫球蛋白 淀粉样蛋白A C反应蛋白 降钙素原 

分 类 号：R725.6[医药卫生—儿科]