摘要
目的探讨孟鲁司特钠颗粒联合吸入用布地奈德混悬液治疗小儿支气管哮喘的临床效果及其对患儿血清抗凝血酶Ⅲ(AT-Ⅲ)、CD5抗原样蛋白(CD5L)和补体3(C3)水平的影响。方法选择2016年6月至2017年7月南阳市中心医院收治的138例支气管哮喘患儿为研究对象,根据治疗方法分为观察组和对照组,每组69例。2组患儿均给予吸氧、镇静、止咳平喘等常规治疗,在常规治疗基础上,对照组患儿给予吸入用布地奈德混悬液雾化吸入,观察组患儿给予吸入用布地奈德混悬液和孟鲁司特钠颗粒联合治疗,疗程均为2周。分别于治疗前及治疗后检测患儿用力肺活量(FVC)、呼气流量峰值(PEF)、第1秒用力呼气量(FEV1)、FEV1/FVC及血清AT-Ⅲ、CD5L和C3水平;观察2组患儿治疗期间不良反应发生情况及肺部哮鸣音、喘息、呼吸困难、咳嗽等临床症状缓解时间,并进行疗效评价。结果观察组患儿肺部哮鸣音、喘息、呼吸困难及咳嗽缓解时间短于对照组(P<0.05)。治疗前2组患儿FVC、PEF、FEV1及FEV1/FVC比较差异无统计学意义(P>0.05)。2组患儿治疗后FVC、PEF、FEV1及FEV1/FVC高于治疗前(P<0.05);治疗后,观察组患儿FVC、PEF、FEV1及FEV1/FVC高于对照组(P<0.05)。治疗前2组患儿血清AT-Ⅲ、CD5L、C3水平比较差异无统计学意义(P>0.05)。与治疗前比较,治疗后2组患儿血清AT-Ⅲ和C3水平降低,CD5L水平升高(P<0.05)。治疗后,观察组患儿血清AT-Ⅲ和C3水平低于对照组,CD5L水平高于对照组(P<0.05)。观察组和对照组患儿治疗总有效率分别为91.31%(53/69)、71.01%(49/69),观察组患儿治疗总有效率高于对照组(χ~2=9.289,P<0.05)。观察组和对照组患儿不良反应发生率分别为1.45%(1/69)、2.90%(2/69),2组患儿不良反应发生率比较差异无统计学意义(χ~2=1.612,P>0.05)。结论孟鲁司特钠颗粒联合吸入用布地奈德混悬液可以快速缓解支气管哮喘患儿的临床症状,改善肺功能,提高治疗效果。
Objective To investigate the effect of montelukast sodium granules combined with budesonide suspension inhalation in the treatment of bronchial asthma in children and its effect on the levels of serum antithrombinⅢ(AT-Ⅲ),CD5 antigen-like protein(CD5 L)and complement 3(C3).Methods A total of 138 children with bronchial asthma in Nanyang Central Hospital from June 2016 to July 2017 were selected as the research objects.The children were divided into the observation group and control group according to the treatment methods,69 cases in each group.The children in the two groups were treated with routine treatment such as oxygen inhalation,sedation,relieving cough and asthma;on the basis of routine treatment,the children in the control group were treated with budesonide suspension inhalation,while the children in the observation group were treated with budesonide suspension inhalation and montelukast sodium granules for two weeks.The forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory volume in one second(FEV1),FEV1/FVC and the levels of serum AT-Ⅲ,CD5 L and C3 of the children were detected before and after treatment.The adverse reactions of children in two groups were observed during treatment.The remission time of clinical symptoms such as wheezing,gasping,dyspnea and cough was observed,and the curative effect was evaluated.Results The remission time of pulmonary wheezing sound,gasping,dyspnea and cough in the observation group was shorter than that in the control group(P<0.05).There was no significant difference in FVC,PEF,FEV1 and FEV1/FVC between the two groups before treatment(P>0.05).The FVC,PEF,FEV1 and FEV1/FVC after treatment were higher than those before treatment in the two groups(P<0.05).The FVC,PEF,FEV1 and FEV1/FVC in the observation group were higher than those in the control group after treatment(P<0.05).There was no significant difference in the levels of serum AT-Ⅲ,CD5 L and C3 between the two groups before treatment(P>0.05).Compared with before treatment,the levels of serum AT-Ⅲand C3 decreased,and the level of serum CD5 L increased in the two groups after treatment(P<0.05).The levels of serum AT-Ⅲand C3 in the observation group were lower than those in the control group,and the level of serum CD5 L in the observation group was higher than that in the control group after treatment(P<0.05).The total effective rate in the observation group and the control group was 91.31%(53/69)and71.01%(49/69),respectively.The total effective rate in the observation group was higher than that in the control group(χ~2=9.289,P<0.05).The incidence of adverse reactions in the observation group and the control group was 1.45%(1/69)and 2.90%(2/69),respectively.There was no significant difference in the incidence of adverse reactions between the two groups(χ~2=1.612,P>0.05).Conclusion Montelukast sodium granules combined with budesonide suspension inhalation can quickly alleviate the clinical symptoms,improve lung function and the therapeutic effect in children with bronchial asthma.
作者
高伟霞
秦小菀
张靖
GAO Wei-xia;QIN Xiao-wan;ZHANG Jing(Department of Emergency Pediatrics,Nanyang Central Hospital,Nanyang 473000,Henan Province,China;Department of Neonatology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第4期368-371,共4页
Journal of Xinxiang Medical University
