雾化吸入布地奈德联合肺泡灌洗治疗重症肺炎效果及对炎症因子水平的影响  

Effectiveness of Nebulized Inhaled Budesonide Combined with Alveolar Lavage in the Treatment of Severe Pneumonia and the Effect on the Levels of Inflammatory Factors

作　　者：胡斯明[1] 莫丽亚[1] 石宝玉 李勇[1] HU Siming;MO Liya;SHI Baoyu;LI Yong(Suzhou Municipal Hospital,Jiangsu Province,Suzhou 215000,China;不详)

机构地区：[1]江苏省苏州市立医院,江苏苏州215000

出　　处：《中国医学创新》2023年第36期64-69,共6页Medical Innovation of China

基　　金：2022年江苏省卫生健康发展研究中心项目(JSHD2022061)。

摘　　要：目的:探究雾化吸入布地奈德联合肺泡灌洗治疗重症肺炎的效果。方法:选择2020年12月—2022年12月在苏州市立医院治疗的重症肺炎患者90例,应用随机数字表法将其分为对照组(肺泡灌洗)及观察组(联合雾化吸入布地奈德)各45例。对比两组治疗效果(退热时间、咳嗽消失时间、肺部啰音消失时间、住院时间)、呼吸力学指标[动态顺应性(Cdyn)、气道阻力(Raw)、呼吸做功(WOB)]、肺功能指标[第1秒用力呼气容积(FEV_(1))、最大通气量(MVV)、呼气流量峰值(PEF)]、应激水平[丙二醛(MDA)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)]、炎症反应介质因子水平[巨噬细胞炎症反应蛋白-1α(MIP-1α)、血小板激活因子(PAF)、可溶性髓细胞触发受体-1(sTREM-1)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)]。结果:对照组退热时间、咳嗽消失时间、肺部啰音消失时间、住院时间均长于观察组,差异均有统计学意义(P<0.05)。治疗前,两组Cdyn、Raw、WOB水平对比,差异均无统计学意义(P>0.05);治疗后,两组Cdyn水平较治疗前均升高,Raw、WOB较治疗前均降低,且观察组均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组FEV_(1)、MVV、PEF水平对比,差异均无统计学意义(P>0.05);治疗后,两组FEV_(1)、MVV、PEF水平较治疗前均升高,且观察组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组MDA、LPO、SOD水平对比,差异均无统计学意义(P>0.05);治疗后,两组SOD水平较治疗前均升高,LPO、MDA水平较治疗前均降低,且观察组SOD高于对照组,LPO、MDA水平均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组MIP-1α、PAF、sTREM-1、IL-6、IL-8、TNF-α水平对比,差异均无统计学意义(P>0.05);治疗后,两组MIP-1α、PAF、sTREM-1、IL-6、IL-8、TNF-α水平较治疗前均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:重症肺炎Objective:To investigate the effect of nebulized inhalation Budesonide combined with alveolar lavage in the treatment of severe pneumonia.Method:A total of ninety patients with severe pneumonia treated in Suzhou Municipal Hospital from December 2020 to December 2022 were selected,and divided into in the control group(alveolar lavage)and the observation group(combined nebulized inhalation budesonide)by random number table method,with 45 cases in each group.The treatment effects(time to fever reduction,time to disappearance of cough,time to disappearance of pulmonary rales,hospitalization time),respiratory mechanics indexes[dynamic compliance(Cdyn),airway resistance(Raw),work of breathing(WOB)],pulmonary function indexes[first second expiratory volume(FEV_(1)),maximum ventilation(MVV),peak expiratory flow(PEF)],stress levels[malondialdehyde(MDA),lipid peroxide(LPO),superoxide dismutase(SOD)],inflammatory response mediator levels[macrophage inflammatory response protein-1α(MIP-1α),platelet-activating factor(PAF),soluble myeloid trigger receptor-1(sTREM-1),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor(TNF-α)]of two groups were compared.Result:The time to fever reduction,time to disappearance of cough,time to disappearance of pulmonary rales and hospital stay in the control group were longer than those in the observation group,the differences were statistically significant(P<0.05).Before treatment,the Cdyn,Raw and WOB levels between the two groups were compared,the differences were statistically significant(P>0.05);after treatment,Cdyn levels were increased compared to those before treatment,Raw and WOB were decreased compared to those before treatment in both groups,and the those in the observation group were better than those in the control group,the differences were statistically significant(P<0.05).Before treatment,the differences in FEV_(1),MVV and PEF levels between the two groups were not significant(P>0.05);after treatment,FEV_(1),MVV and PEF levels were increased compared to those before tr

关 键 词：雾化吸入 布地奈德 肺泡灌洗 重症肺炎 炎症因子 肺功能 呼吸功能 

分 类 号：R563.1[医药卫生—呼吸系统]