氨溴索和布地奈德联合纤维支气管镜肺泡灌洗在闭塞性细支气管炎患儿中的应用效果分析  

Analysis on the application effect of ambroxol,budeside combined with bronchoscopic alveolar lavage in children with obliterative bronchiolitis

作　　者：蓝海珍 孙媛媛[2] LAN Hai-zhen;SUN Yuan-yuan(Respiratory Department,Lishui City Central Hospital,Lishui,Zhejiang 323000,China;不详)

机构地区：[1]丽水市中心医院呼吸科,浙江丽水323000 [2]温州医科大学附属第一医院呼吸科

出　　处：《中国妇幼保健》2024年第23期4634-4639,共6页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2020KY178)。

摘　　要：目的分析氨溴索、布地奈德联合纤维支气管镜肺泡灌洗在闭塞性细支气管炎患儿中的应用效果。方法将2020年9月—2022年9月于丽水市中心医院接受治疗的80例闭塞性细支气管炎患儿依据随机数字表法分为两组。对照组40例予以纤维支气管镜肺泡灌洗治疗,治疗组40例在纤维支气管镜肺泡灌洗基础上予以氨溴索、布地奈德联合治疗。比较两组气促、咳嗽、憋喘及肺部啰音消失时间,对比两组治疗前后白细胞介素-17(IL-17)、γ-干扰素(IFN-γ)、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、金属蛋白酶抑制剂-1(TIMP-1)水平,比较两组治疗前后的肺功能指标[呼吸频率(RR)、潮气量(TV)、呼气峰流速(PEF)、功能残气量(FRC)、有效呼吸道阻力(Reff)],并评价两组的临床疗效及安全性。结果治疗组的临床疗效优于对照组(P<0.05)。治疗组的气促、咳嗽、憋喘及肺部啰音消失时间均短于对照组(均P<0.05)。治疗后,治疗组IL-17、INF-γ、PCT、hs-CRP水平分别为(12.31±2.81)ng/L、(131.39±10.36)ng/L、(4.37±1.18)pg/ml、(20.44±5.33)mg/L,较对照组的(15.44±3.43)ng/L、(147.22±9.23)ng/L、(7.65±2.03)pg/ml、(31.88±6.53)mg/L均明显下降(均P<0.05)。治疗后,治疗组MMP-9、TIMP-1水平分别为(1331.58±76.26)ng/ml、(237.46±10.32)ng/ml,较对照组的(1532.09±93.41)ng/ml、(251.01±11.38)ng/ml水平均明显降低,差异均有统计学意义(均P<0.05)。治疗后,治疗组的RR、PEF、FRC、Reff分别为(16.58±3.26)次/min、(40.39±7.31)L/min、(134.26±26.51)ml、(3.22±0.86)kPa/(L·s),均低于对照组的(22.09±3.41)次/min、(47.28±8.33)L/min、(171.28±31.33)ml、(4.78±1.18)kPa/(L·s),治疗组的TV为(7.26±1.32)ml/kg,高于对照组的(6.61±1.38)ml/kg,差异均有统计学意义(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论氨溴索、布地奈德联合纤维支气管镜肺泡灌洗对闭塞性细支气管炎患�Objective To analyze the application effect of ambroxol,budeside combined with bronchoscopic alveolar lavage in children with obliterative bronchiolitis.Methods Eighty children with obliterative bronchiolitis treated in Lishui City Central Hospital from September 2020 to September 2022 were randomly divided into two groups according to random number table.Forty children in control group were treated with bronchoscopic alveolar lavage,forty children in treatment group were treated with ambroxol and budesonide on the basis of bronchoscopic alveolar lavage.The disappearance time of shortness of breath,cough,wheezing,and pulmonary rales in the two groups was compared,the levels of interleukin-17(IL-17),interferon-γ(IFN-γ),procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase-9(MMP-9),and metalloproteinase inhibitor-1(TIMP-1)before and after treatment were compared between the two groups.The pulmonary function indexes[respiratory rate(RR),tidal volume(TV),peak expiratory flow(PEF),functional residual capacity(FRC),effective respiratory resistance(Reff)]before and after treatment were compared between the two groups.The clinical efficacies and safeties of the two groups were evaluated.Results The clinical efficacy of treatment group was higher than that of control group(P<0.05).The disappearance time of shortness of breath,cough,wheezing,and pulmonary rales in treatment group was shorter than that in control group(P<0.05).After treatment,IL-17,INF-γ,PCT,and hs-CRP levels in treatment group were(12.31±2.81)ng/L,(131.39±10.36)ng/L,(4.37±1.18)pg/ml,and(20.44±5.33)mg/L,respectively,which were statistically significantly lower than those in control group[(15.44±3.43)ng/L,(147.22±9.23)ng/L,(7.65±2.03)pg/ml,(31.88±6.53)mg/L](P<0.05).After treatment,MMP-9 and TIMP-1 levels in treatment group were(1331.58±76.26)ng/ml and(237.46±10.32)ng/ml,respectively,which were statistically significantly lower than those in control group[(1532.09±93.41)ng/ml,(251.01±11.38)ng/ml](P<0.05).After

关 键 词：闭塞性细支气管炎 氨溴索 布地奈德 纤维支气管镜 肺泡灌洗 临床疗效 肺功能 

分 类 号：R725.6[医药卫生—儿科]