阿奇霉素及丙氧鸟苷雾化吸入治疗小儿支气管肺炎疗效及炎症因子影响

摘要/Abstract

摘要： 目的探讨阿奇霉素及丙氧鸟苷雾化吸入治疗方法对支气管肺炎患儿的临床疗效以及对炎症因子水平的影响。方法选取2021年8月—2022年8月山东省烟台市北海医院收治的支气管肺炎患儿84例作为研究对象,根据抛币法将患儿随机分为对照组和研究组,每组42例。对照组接受丙氧鸟苷雾化吸入治疗,研究组接受阿奇霉素联合丙氧鸟苷雾化吸入治疗,比较两组临床症状消失时间、住院时间、治疗总有效率、炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）]水平、肺功能[用力肺活量（FVC）、第一秒用力呼气量（FEV₁）、FEV₁/FVC]。结果研究组患儿咳嗽缓解时间、发热消失时间、气促消失时间以及住院时间均短于对照组,差异有统计学意义（P<0.05）。研究组患儿治疗总有效率高于对照组,差异有统计学意义（P<0.05）。治疗前,两组TNF-α、IL-1β水平比较,差异无统计学意义（P>0.05）;治疗后,两组TNF-α、IL-1β水平均降低,且研究组低于对照组,差异有统计学意义（P<0.05）。治疗前,两组FVC、FEV₁、FEV₁/FVC水平比较,差异无统计学意义（P>0.05）;治疗后,两组FVC、FEV₁、FEV₁/FVC水平均升高,且研究组高于对照组,差异有统计学意义（P<0.05）。结论支气管肺炎患儿通过阿奇霉素与丙氧鸟苷雾化吸入联合治疗,疗效确切,可明显缩短临床症状改善时间,减轻机体炎性反应,改善肺功能,值得临床使用。

关键词: 阿奇霉素, 丙氧鸟苷, 小儿支气管肺炎, 疗效, 炎症因子

Abstract: Objective To investigate the clinical efficacy of azithromycin and propoxyguanosine aerosol inhalation in children with bronchopneumonia and the effect on the level of inflammatory factors. Methods A total of 84 children with bronchopneumonia admitted to the pediatrics department of Yantai Beihai Hospital from August 2021 to August 2022 were selected as the subjects of this study. The children were randomly divided into control group and study group according to coin toss method. Among them, 42 cases in the control group received atomized inhalation therapy of propioguanosine, and 42 cases in the study group. Azithromycin combined with propoxyguanosine atomized inhalation therapy, the duration of clinical symptom disappearance, length of hospital stay, total response rate, levels of inflammatory factors (TNF-α, interleukin-1β), lung function [(forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and ratio of forced expiratory volume in the first second to forced vital capacity (FEV₁/FVC) were compared between the two groups )]. Results The duration of cough relief, fever disappearance, shortness of breath disappearance and hospital stay in the study group were shorter than those in the control group (P<0.05). The total effective rate of the study group was higher than that of the control group (P<0.05). The levels of TNF-α and IL-1β in the two groups before treatment were compared (P>0.05), and the levels of TNF-α and IL-1β in the two groups were decreased after treatment, and the levels in the study group were lower than those in the control group (P<0.05). The levels of FVC, FEV₁ and FEV₁/FVC in both groups before treatment (P>0.05), and the levels of FVC, FEV₁ and FEV₁/FVC in both groups were improved after treatment, and the study group was higher than the control group (P<0.05). Conclusion The combined treatment of azithromycin and propoxyguanyside aerosol inhalation in children with bronchopneumonia has definite curative effect, can significantly shorten the improvement time of clinical symptoms, reduce the inflammatory reaction of the body, improve lung function, and is worthy of clinical use.

Key words: azithromycin, propoxyguanosine, bronchial pneumonia in children, efficacy, inflammatory factor

中图分类号:

R725.6

孙百弟. 阿奇霉素及丙氧鸟苷雾化吸入治疗小儿支气管肺炎疗效及炎症因子影响[J]. 中华养生保健, 2023, 41(15): 41-45.

SUN Bai-di. Effect of Aerosol Inhalation of Azithromycin and Guanosine Propionate on Children with Bronchopneumonia and Influence of Inflammatory Factors[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(15): 41-45.

参考文献

[1] 李俊,周杰,陈丽霞,等.干扰素联合沙丁胺醇雾化配合氧疗在儿童支气管肺炎中的应用[J]. 中国临床药理学杂志,2022,38(16):1843-1846.
[2] 戴晓红,徐燕燕,耿荣.支气管肺炎患儿血清galectin-1、galectin-2表达变化及临床意义[J].标记免疫分析与临床,2022,29(4):589-594.
[3] 潘小翠,符青,符顺丹,等.支气管肺炎患儿血清基质金属蛋白酶-9、转化生长因子-β1表达水平及临床意义[J].中国临床医生杂志,2022,50(10):1245-1248.
[4] 李明阳,辛斐斐.血清PCT、IL-6水平与支气管肺炎患儿阿奇霉素治疗效果的相关性[J].医药论坛杂志,2022,43(14):23-25,29.
[5] 胡亚美,江载芳.诸福棠实用儿科学[M].第7版.北京:人民卫生出版社,2005:1199-1200.
[6] 谭敏,高玉梅.临床护理路径在小儿支气管肺炎患者中的效果及对凝血功能的影响[J].血栓与止血学,2022,28(3):695-696.
[7] 耿翠. 支气管肺炎患儿血清肺表面活性蛋白D、白细胞介素-6、可溶性细胞间黏附分子-1水平与肺功能的关系[J].中国临床医生杂志,2020,48(12):1497-1500.
[8] 李丹,肖凤林,吕芹香.综合护理联合穴位贴敷对小儿支气管肺炎患儿的影响[J].齐鲁护理杂志,2022,28(12):55-58.
[9] 白冬梅,魏国烨.盐酸氨溴索辅助治疗小儿急性支气管肺炎临床疗效及安全性分析[J].贵州医药,2022,46(8):1242-1243.
[10] 齐欣,邵瑞娜,代雪曼,等. PDCA循环护理对支气管肺炎患儿康复效果及治疗依从性的影响[J]. 河北医药,2022,44(6):948-950,954.
[11] 陈兴碧,陈星涛.童趣化心理干预模式在儿童支气管肺炎中的应用效果及对治疗依从性的影响[J].川北医学院学报,2021,36(10):1399-1402.
[12] 王成兴,曾山崎,杨平,等.巨细胞病毒嵌合癌胚抗原介导单纯疱疹病毒胸苷激酶联合丙氧鸟苷自杀基因体系靶向性治疗结肠癌的效果[J].中国医药导报,2015(17):13-15,23.
[13] 赵梦娇,王玺.阿奇霉素联合甲泼尼龙治疗小儿肺炎支原体肺炎的效果及胸部CT征象变化[J].影像科学与光化学,2022,40(6):1550-1554.
[14] 王芝芳,何璐伟,朱佳燕.孟鲁司特和布地奈德联合阿奇霉素对小儿肺炎支原体肺炎患者疗效的影响[J]. 中国临床药理学杂志,2022,38(16):1851-1854.
[15] 石颖玉,罗明鑫,华山.小儿肺热清颗粒联合阿奇霉素对儿童肺炎支原体肺炎患者的临床疗效[J].中成药,2022,44(9):3079-3081.
[16] 赵琦,袁红亮,李珊珊.加味麻杏石甘汤联合阿奇霉素治疗小儿支原体肺炎疗效及对机体细胞免疫应答、血清Fbg和G-CSF水平的影响[J].现代中西医结合杂志,2022,31(10):1399-1402.
[17] 胡少华,石锦梅,汪江涛.桑杏汤加减联合阿奇霉素对肺炎支原体感染患儿的疗效[J].西北药学杂志,2022,37(2):140-143.