雾化吸入乙酰半胱氨酸联合布地奈德治疗婴幼儿肺炎临床疗效观察

王吉胜; 吴立存; 吴慧; 王磊; 周瑞

doi:10.16766/j.cnki.issn.1674-4152.002101

雾化吸入乙酰半胱氨酸联合布地奈德治疗婴幼儿肺炎临床疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002101

王吉胜¹,
吴立存¹,
吴慧¹,
王磊²,
周瑞^2, ,

1.
萧县人民医院暨蚌埠医学院第一附属医院萧县医院儿科，安徽宿州 235200
2.
蚌埠医学院第一附属医院儿科，安徽蚌埠 233004

基金项目:

安徽省高校自然科学研究重点项目 KJ2019A0342

国家卫生计生委医药卫生科技发展研究中心临床科研专项课题 W2016EWAH06

详细信息

通讯作者:
周瑞, E-mail: 1176034941@qq.com

中图分类号: R722.135 R974
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- 被引次数: 0
出版历程
- 收稿日期: 2021-01-15
- 网络出版日期: 2022-02-15

Clinical effect and inflammatory factor analysis of nebulised inhalation of acetylcysteine solution combined with budesonide in the treatment of infant pneumonia

1.
Department of Pediatrics, the People's Hospital of Xiao County and Xiao County Hospital of the First Affiliated of Bengbu Medical College, Suzhou, Anhui 235200, China

摘要

摘要: 目的探究雾化吸入乙酰半胱氨酸溶液联合布地奈德治疗婴幼儿肺炎的临床疗效及对炎性因子的影响。方法选取2019年7月—2020年8月萧县人民医院收治的婴幼儿肺炎患儿66例，根据用药方案分为观察组(35例)和对照组(31例)。对照组予以基础对症治疗和雾化吸入布地奈德治疗，2 mL/次, 2次/d，连续使用7 d；观察组在对照组治疗的基础上予以联合雾化吸入乙酰半胱氨酸溶液，0.3 g/次，2次/d，连续使用7 d。分析2组患儿的临床疗效、各项临床症状的消失时间及不良反应发生率，并记录2组患儿治疗前后的血清炎症因子及肺功能指标的变化。结果观察组临床治疗总有效率(88.57%)高于对照组(64.52%，χ²=5.147，P=0.020)。观察组肺炎患儿的临床症状消失时间与体温恢复正常时间均显著短于对照组(均P＜0.05)。2组肺炎患儿的不良反应发生率比较，差异无统计学意义(P＞0.05)。2组的血清干扰素-γ(IFN-γ)、白介素-6(IL-6)、白介素-2(IL-2)、C反应蛋白(CRP)及降钙素原(PCT)均较治疗前降低，但观察组的各炎性因子水平明显低于对照组(均P＜0.05)。2组肺炎患儿的肺功能指标均较治疗前升高，但观察组较对照组升高更明显(均P＜0.05)。结论乙酰半胱氨酸溶液联合布地奈德雾化吸入治疗婴幼儿肺炎效果显著，能明显缩短各项症状消失时间，促使血清炎症因子降低，有助于肺功能恢复，安全性较高，值得临床推广。
- 乙酰半胱氨酸 /
- 布地奈德 /
- 婴幼儿 /
- 肺炎 /
- 炎性因子 /
- 雾化吸入
Abstract: Objective To explore the clinical effect of nebulised inhalation of acetylcysteine solution combined with budesonide in the treatment of infant pneumonia and its effect on inflammatory factors. Methods Sixty-six infants and young children with pneumonia admitted to the hospital from July 2019 to August 2020 were selected. They were divided into the control group (n=31) and observation group (n=35) according to the drug regimen. The control group was treated with basic symptomatic treatment and 2 mL of budesonide twice a day for 7 days. On the basis of treatment of the control group, the observation group was treated with combined atomisation inhalation of 0.3 g acetylcysteine solution twice a day for 7 days. The clinical efficacy, disappearance time of clinical symptoms and occurrence of adverse reactions in both groups were compared, and the differences of serum inflammatory factors and lung function indicators in both groups before and after treatment were compared. Results The total effective rate (88.57%) of the observation group was higher than that of the control group (64.52%, χ²=5.147, P=0.020). The disappearance time of clinical symptoms and the temperature recovery time in the observation group were obviously shorter than those in the control group (all P < 0.05). The incidence of adverse reactions in both groups showed no significant difference (P>0.05). Serum interferon-γ, interleukin-6, interleukin-2, procalcitonin and C-reactive protein in both groups were significantly lower after treatment than before treatment, but the levels of inflammatory factors in the observation group were remarkably lower than those in the control group (all P < 0.05). The lung function indexes of both groups were significantly improved after treatment compared with those before treatment, and the improvement was more obvious in the observation group than in the control group (all P < 0.05). Conclusion Nebulised inhalation of acetylcysteine solution combined with budesonide in the treatment of infant pneumonia has significant clinical efficacy. It can significantly shorten the disappearance time of various symptoms, reduce serum inflammation factors and help restore lung function. Moreover, it is relatively safe and is worthy of clinical promotion.
- Acetylcysteine /
- Budesonide /
- Infant /
- Pneumonia /
- Inflammatory factor /
- Aerosol inhalation

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表 1 2组肺炎患儿一般资料比较

组别	例数	性别(例)		年龄(x±s，岁)
组别	例数	男	女	年龄(x±s，岁)
观察组	35	17	18	3.86±0.86
对照组	31	16	15	3.95±0.83
统计量		0.061^a		0.438^b
P值		0.805		0.854
注：^a为χ²值, ^b为t值。

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表 2 2组肺炎患儿总有效率比较

组别	例数	痊愈[例(%)]	显效[例(%)]	好转[例(%)]	无效[例(%)]	总有效率(%)
观察组	35	22(62.86)	9(25.71)	3(8.57)	1(2.86)	88.57(31/35)
对照组	31	14(45.16)	6(19.35)	6(19.35)	5(16.13)	64.52(20/31)
注：2组总有效率比较，χ²=5.147，P=0.020。

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表 3 2组肺炎患儿临床症状消失时间比较(x±s，d)

组别	例数	体温恢复正常时间	气促喘息时间	咳嗽消失时间	肺部啰音消失时间
观察组	35	2.31±0.76	3.22±0.87	4.10±1.16	4.87±1.11
对照组	31	3.84±1.03	4.25±1.34	5.73±1.62	6.69±2.07
t值		6.918	3.745	4.739	4.522
P值		< 0.001	< 0.001	< 0.001	< 0.001

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表 4 2组肺炎患儿血清炎症因子比较(x±s)

组别	例数	IFN-γ(ng/L)		IL-6(ng/L)		IL-2(ng/L)		PCT(μg/L)		CRP(mg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	35	25.66±5.54	17.05±3.68^a	43.86±8.86	22.10±6.25^a	326.67±31.34	200.14±25.28^a	21.88±6.87	8.47±3.38^a	0.97±0.29	0.41±0.28^a
对照组	31	25.43±5.21	20.04±4.12^a	44.51±8.75	31.33±7.76^a	327.59±30.28	285.26±26.45^a	22.01±7.25	13.24±4.49^a	0.96±0.31	0.68±0.32^a
t值		0.173	3.115	0.299	5.347	0.121	13.359	0.075	4.909	0.135	3.656
P值		0.863	0.003	0.766	< 0.001	0.904	< 0.001	0.941	< 0.001	0.893	0.001
注：与同组内治疗前比较，^aP＜0.05。

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表 5 2组肺炎患儿肺功能指标比较(x±s)

组别	例数	FVC(%)		PEF(L/s)		FEV₁(L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	35	54.13±6.81	77.84±7.11^a	2.01±0.56	2.75±0.65^a	1.21±0.30	1.98±0.38^a
对照组	31	53.81±6.75	70.25±6.72^a	2.02±0.57	2.38±0.60^a	1.23±0.32	1.57±0.34^a
t值		0.191	4.441	0.072	2.392	0.262	4.595
P值		0.849	< 0.001	0.943	0.020	0.794	< 0.001
注：与同组内治疗前比较，^aP＜0.05。

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表 6 2组肺炎患儿的不良反应发生情况比较

组别	例数	恶心[例(%)]	呕吐[例(%)]	皮疹[例(%)]	鼻出血[例(%)]	总不良反应发生率(%)
观察组	35	1(2.86)	1(2.86)	1(2.86)	1(2.86)	11.43(4/35)
对照组	31	1(3.23)	0(0.00)	1(3.23)	0(0.00)	6.45(2/31)
注：2组总不良反应发生率比较，χ²=0.075，P=0.785。

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