布地奈德雾化吸入辅助治疗小儿支原体肺炎对患儿炎性因子、免疫功能及肺功能的影响
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摘要
目的:观察布地奈德雾化吸入辅助治疗对支原体肺炎(MPP)患儿血清炎性因子、免疫功能及肺功能的影响。方法:选取2015年1月-2017年12月笔者所在医院儿科病区住院治疗的150例MPP患儿,采用随机数字表法将其分为对照组和观察组各75例。对照组采用常规治疗,观察组在对照组基础上应用布地奈德驱动雾化吸入治疗。治疗两周后,观察两组血清炎性因子肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、免疫功能指标(IgA,IgM,IgG)及肺功能指标[第1秒用力呼气容积占预计值的百分比(FEV_1%-pred)、第1秒用力呼气容积占用力肺活量的百分比(FEV_1/FVC)及残气量占预计值的百分比(RV%-pred)]的变化。结果:治疗后,两组TNF-α、IL-2及IL-6均较治疗前降低(P<0.05),观察组TNF-α、IL-2及IL-6分别为(4.72±1.40)ng/L、(101.11±26.23)ng/L、(9.61±4.45)ng/L,均低于对照组,差异有统计学意义(P<0.05);治疗后,两组IgA、IgM水平均较治疗前降低,IgG水平升高(P<0.05),且观察组均低于对照组,差异有统计学意义(P<0.05);治疗后,两组FEV_1%-pred和FEV_1/FVC均较治疗前明显升高,观察组治疗后FEV_1%-pred、FEV_1/FVC分别为(95.20±13.73)%、(86.09±7.52)%,均高于对照组,差异有统计学意义(P<0.05);治疗后两组RV%-pred较治疗前明显降低,观察组RV%-pred为(81.00±15.55)%低于对照组的(89.99±15.06)%,差异有统计学意义(P<0.05)。结论:布地奈德雾化吸入辅助治疗MPP可有效抑制炎症反应,改善患儿免疫功能和肺功能,对临床治疗有重要意义。
Objective:To observe the effect on serum inflammatory factors,immune function and pulmonary function of Budesonide aerosol inhalation combined in children with mycoplasma pneumonia(MPP).Method:A total of 150 cases of MPP children hospitalized in the pediatric ward of our hospital from January 2015 to December 2017 were selected.They were divided into control group and observation group according to random number table,75 cases in each group.The control group was treated with conventional treatment,the observation group was treated with Budesonide suspension atomizing inhalation treatment based on the control group.2 weeks after the treatment,the serum inflammatory factors(TNF-α,IL-2 and IL-6),and Immune function(IgA,IgM and IgG),and pulmonary function(FEV_1/FVC,FEV_1%-pred and RV%-pred) of the two groups were observed.Result:After treatment,TNF-α,IL-2 and IL-6 of the two groups were decreased with before(P<0.05).TNF-α,IL-2 and IL-6 of the observation group were(4.72±1.40)ng/L、(101.11±26.23)ng/L、(9.61±4.45)ng/L,respectively,lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,IgM and IgA of the two groups were decreased and IgG were increased with before(P<0.05),and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,FEV_1%-pred and FEV_1/FVC of the two groups were increased with before(P<0.05),FEV_1%-pred and FEV_1/FVC of the observation group were(95.20±13.73)% and(86.09±7.52)%,respectively,higher than those of the control group,the differences were statistically significant(P<0.05).After treatment,the RV%-pred of the two groups were decreased with before(P<0.05),and the RV%-pred of the observation group was(81.00±15.55)%,lower than that the control group of(89.99±15.06)%,the difference was statistically significant(P<0.05).Conclusion:Budesonide spray inhalation combined can significantly improve pulmonary function in treatment of children with MPP,and has stronger effect of inhibiting inflammatory reaction and regulating the immune function,for the clinical treatment it has important significance.
Objective:To observe the effect on serum inflammatory factors,immune function and pulmonary function of Budesonide aerosol inhalation combined in children with mycoplasma pneumonia(MPP).Method:A total of 150 cases of MPP children hospitalized in the pediatric ward of our hospital from January 2015 to December 2017 were selected.They were divided into control group and observation group according to random number table,75 cases in each group.The control group was treated with conventional treatment,the observation group was treated with Budesonide suspension atomizing inhalation treatment based on the control group.2 weeks after the treatment,the serum inflammatory factors(TNF-α,IL-2 and IL-6),and Immune function(IgA,IgM and IgG),and pulmonary function(FEV_1/FVC,FEV_1%-pred and RV%-pred) of the two groups were observed.Result:After treatment,TNF-α,IL-2 and IL-6 of the two groups were decreased with before(P<0.05).TNF-α,IL-2 and IL-6 of the observation group were(4.72±1.40)ng/L、(101.11±26.23)ng/L、(9.61±4.45)ng/L,respectively,lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,IgM and IgA of the two groups were decreased and IgG were increased with before(P<0.05),and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,FEV_1%-pred and FEV_1/FVC of the two groups were increased with before(P<0.05),FEV_1%-pred and FEV_1/FVC of the observation group were(95.20±13.73)% and(86.09±7.52)%,respectively,higher than those of the control group,the differences were statistically significant(P<0.05).After treatment,the RV%-pred of the two groups were decreased with before(P<0.05),and the RV%-pred of the observation group was(81.00±15.55)%,lower than that the control group of(89.99±15.06)%,the difference was statistically significant(P<0.05).Conclusion:Budesonide spray inhalation combined can significantly improve pulmonary function in treatment of children with MPP,and has stronger effect of inhibiting inflammatory reaction and regulating the immune function,for the clinical treatment it has important significance.
引文
[1]李万琼.阿奇霉素联合布地奈德混悬液雾化吸入治疗小儿肺炎支原体肺炎体会[J].贵州医药,2016,40(10):1080.
[2]张利琴.阿奇霉素联合孟鲁司特治疗小儿肺炎支原体肺炎的临床疗效观察[J].内蒙古医学杂志,2013,45(6):658-659.
[3]中华医学会儿科学分会呼吸学组,《中华实用儿科临床杂志》编辑委员会.儿童肺炎支原体肺炎诊治专家共识(2015年版)[S].中华实用儿科临床杂志,2015,30(17):1304-1308.
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[5]孙红,孙红妹.肺炎支原体直接损伤及其免疫学致病机制研究进展[J].中华微生物学和免疫学杂志,2015,31(1):65-68.
[6]杨晓鸿.布地奈德雾化吸入联合阿奇霉素序贯疗法治疗小儿肺炎支气管肺炎效果观察[J].中国乡村医药,2017,2(6):46-47.
[7]李亚宏.阿奇霉素联合布地奈德混悬液雾化吸入治疗小儿肺炎支气管肺炎60例临床观察[J/OL].临床医药文献电子杂志,2018,5(40):147,157.
[8]申昆玲,邓力,李云珠,等.糖皮质激素雾化吸入疗法在儿科应用的专家共识(2014年修订版)[S].临床儿科杂志,2014,32(6):504-511.
[9]覃东.阿奇霉素联合布地奈德雾化吸入治疗小儿肺炎支气管肺炎[J].中国工程医学,2015,23(1):116.
[10]Ma Y J,Wang S M,Cho Y H,et al.Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan:A nationwide surveillance[J].J Microbiol Immunol Infect,2015,48(6):632-638.
[11]华孝真,陈瑾,余宇龙,等.地奈德雾化吸入对肺炎支原体肺炎患儿的治疗效果及其对免疫球蛋白水平的影响分析[J].医药前沿,2018,8(4):168-169.
[12]谭义林,叶池林.布地奈德雾化吸入联合阿奇霉素对支原体肺炎患儿肺功能及血清炎性因子、免疫功能的影响[J].海南医学院学报,2016,22(22):2782-2784,2788.
[2]张利琴.阿奇霉素联合孟鲁司特治疗小儿肺炎支原体肺炎的临床疗效观察[J].内蒙古医学杂志,2013,45(6):658-659.
[3]中华医学会儿科学分会呼吸学组,《中华实用儿科临床杂志》编辑委员会.儿童肺炎支原体肺炎诊治专家共识(2015年版)[S].中华实用儿科临床杂志,2015,30(17):1304-1308.
[4]Jain S,Williams D J,Amold S R,et al.Community-acquired pneumonia requiring hospitalization among U.S.children[J].N Engl J Med,2015,372(9):835-845.
[5]孙红,孙红妹.肺炎支原体直接损伤及其免疫学致病机制研究进展[J].中华微生物学和免疫学杂志,2015,31(1):65-68.
[6]杨晓鸿.布地奈德雾化吸入联合阿奇霉素序贯疗法治疗小儿肺炎支气管肺炎效果观察[J].中国乡村医药,2017,2(6):46-47.
[7]李亚宏.阿奇霉素联合布地奈德混悬液雾化吸入治疗小儿肺炎支气管肺炎60例临床观察[J/OL].临床医药文献电子杂志,2018,5(40):147,157.
[8]申昆玲,邓力,李云珠,等.糖皮质激素雾化吸入疗法在儿科应用的专家共识(2014年修订版)[S].临床儿科杂志,2014,32(6):504-511.
[9]覃东.阿奇霉素联合布地奈德雾化吸入治疗小儿肺炎支气管肺炎[J].中国工程医学,2015,23(1):116.
[10]Ma Y J,Wang S M,Cho Y H,et al.Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan:A nationwide surveillance[J].J Microbiol Immunol Infect,2015,48(6):632-638.
[11]华孝真,陈瑾,余宇龙,等.地奈德雾化吸入对肺炎支原体肺炎患儿的治疗效果及其对免疫球蛋白水平的影响分析[J].医药前沿,2018,8(4):168-169.
[12]谭义林,叶池林.布地奈德雾化吸入联合阿奇霉素对支原体肺炎患儿肺功能及血清炎性因子、免疫功能的影响[J].海南医学院学报,2016,22(22):2782-2784,2788.