布地奈德联合沙丁胺醇治疗小儿哮喘合并呼吸道病毒感染的疗效及对肺功能的影响探讨  

Efficacy of budesonide combined with salbutamol in the treatment of children with asthma complicated by respiratory virus infection and its influence on pulmonary function

作　　者：张丽丽[1] 黄洁 ZHANG Li-li;HUANG Jie(Department of Pediatrics,Liaocheng People's Hospital of Dongchangfu District,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院东昌府院区儿科,252000

出　　处：《中国实用医药》2022年第18期15-19,共5页China Practical Medicine

摘　　要：目的 探讨布地奈德联合沙丁胺醇治疗小儿哮喘合并呼吸道病毒感染的疗效及对肺功的影响。方法 80例哮喘合并呼吸道病毒感染的患儿,采用随机数字表法分为对照组和观察组,各40例。对照组患儿采用沙丁胺醇雾化吸入治疗,观察组患儿在对照组基础上采用布地奈德雾化吸入治疗。对比两组患儿治疗效果、症状缓解或消失时间、哮喘发作次数和上呼吸道感染次数及治疗前后血清气道重塑指标[转化生长因子β(TGF-β)、基质金属蛋白酶9(MMP-9)、组织型基质金属蛋白酶抑制剂1(TIMP-1)]、肺功能指标[用力肺活量(FVC)、呼气流速峰值(PEFR)、第1秒用力呼气容积(FEV1)]、血清炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)]。结果 观察组总有效率为97.50%,高于对照组的82.50%,差异具有统计学意义(P<0.05)。观察组发热、气促、咳嗽、喘憋缓解时间及哮鸣音消失时间分别为(2.81±0.40)、(3.02±0.89)、(3.29±0.43)、(3.40±0.39)、(4.42±0.71)d,均短于对照组(3.49±0.73)、(6.11±1.08)、(7.59±0.46)、(5.29±0.87)、(9.15±1.03)d,差异具有统计学意义(P<0.05)。治疗后,两组TGF-β、MMP-9、TIMP-1水平均低于治疗前,且观察组TGF-β(82.99±7.01)ng/L、MMP-9(81.42±7.96)ng/ml、TIMP-1(55.39±6.82)ng/ml低于对照组的(97.84±9.36)ng/L、(99.72±10.83)ng/ml、(66.71±9.09)ng/ml,差异具有统计学意义(P<0.05)。治疗后,两组FVC、PEFR、FEV1均高于治疗前,且观察组FVC(3.38±0.59)L、PEFR(3.41±0.88)L/min、FEV1(3.57±0.81)L高于对照组的(2.21±0.35)L、(2.40±0.69)L/min、(2.32±0.49)L,差异具有统计学意义(P<0.05)。治疗后,两组IL-6、IL-8、CRP水平均低于治疗前,且观察组IL-6(39.28±5.7)ng/L、IL-8(32.17±7.92)ng/L、CRP(8.20±1.07)mg/L低于对照组的(53.95±8.64)ng/L、(41.95±8.73)ng/L、(11.77±2.92)mg/L,差异具有统计学意义(P<0.05)。观察组哮喘发作次数(3.28±0.78)次、上呼吸道感染次数(1.19±0.30)次Objective To discuss the efficacy of budesonide combined with salbutamol in the treatment of children with asthma complicated by respiratory virus infection and its influence on pulmonary function.Methods A total of 80 children with asthma complicated by respiratory virus infection were divided into control group and observation group by random numerical table, with 40 cases in each group. Children in the control group were treated with salbutamol atomization inhalation, and children in the observation group were treated with budesonide atomization inhalation on the basis of the control group. Both groups were compared in terms of therapeutic effect, symptom relief or disappearance time, frequency of asthma attacks and the frequency of upper respiratory tract infections, and the serum airway remodeling indexes [transforming growth factor-β(TGF-β),matrix metalloproteinase-9(MMP-9), tissue inhibitor of metalloproteinases-1(TIMP-1)], pulmonary function indicators [forced vital capacity(FVC), peak expiratory flow rate(PEFR), forced expiratory volume in the 1st second(FEV1)], serum inflammatory factors [interleukin-6(IL-6), interleukin-8(IL-8), C-reactive protein(CRP)] before and after treatment. Results The total effective rate in the observation group was 97.50%, which was higher than 82.50% in the control group, and the difference was statistically significant(P<0.05). The time to relieve fever, shortness of breath, cough, wheezing and disappearance time of wheezing in the observation group were(2.81±0.40),(3.02±0.89),(3.29±0.43),(3.40±0.39) and(4.42±0.71) d, which were shorter than(3.49±0.73),(6.11±1.08),(7.59±0.46),(5.29±0.87) and(9.15±1.03) d in the control group, and the differences were statistically significant(P<0.05). After treatment, the levels of TGF-β, MMP-9 and TIMP-1 in the two groups were lower than those before treatment in this group, and the TGF-β(82.99±7.01) ng/L, MMP-9(81.42±7.96) ng/ml, TIMP-1(55.39±6.82) ng/ml in the observation group were lower than(97.84±9.36) ng/L,(99.72±1

关 键 词：小儿哮喘 呼吸道病毒感染 布地奈德 雾化吸入 肺功能 

分 类 号：R725.6[医药卫生—儿科]