吸入用布地奈德混悬液治疗儿童哮喘的临床效果分析

doi:10.3969/j.issn.2095-3755.2019.03.008

摘要/Abstract

摘要：

目的探讨吸入用布地奈德混悬液(普米克令舒)治疗儿童哮喘的临床效果。方法收集2017年5月至2019年5月在沈阳二四五医院诊治的107例哮喘患儿作为研究对象,其中52例采用常规基础治疗,排除中途失访的2例患儿,将完成治疗的50例患儿作为对照组,55例在常规治疗的基础上增加吸入用布地奈德混悬液雾化吸入治疗,排除中途失访的3例患儿,将完成治疗的52例患儿作为研究组。比较两组患儿的临床治疗效果,以及CD4 ⁺ T淋巴细胞变化情况,以及C反应蛋白(CRP)、白细胞介素6(IL-6)、第1秒用力呼气容积(FEV₁)和用力肺活量(FVC)水平的变化情况。结果治疗7d后,研究组患儿总有效率为96.2%(50/52),明显高于对照组的80.0%(40/50),差异有统计学意义(χ ²=4.94,P<0.05)。治疗7d后,研究组患儿CD4 ⁺ T淋巴细胞占总淋巴细胞的百分比[(34.32±4.15)%]、CD4 ⁺/CD8 ⁺ T淋巴细胞比值(1.20±0.28)、CRP水平[(12.38±2.98)mg/L]、IL-6水平[(54.23±6.54)ng/L]较对照组[分别为(45.37±3.08)%、1.67±0.16、(35.82±7.31)mg/L、(74.24±8.11)ng/L]明显下降,差异均有统计学意义(t值分别为13.35、9.10、18.54、11.99,P值均<0.05)。治疗7d后,研究组FEV₁水平[(2.41±0.32)L]和FVC水平[(1.45±0.28)L]均明显高于对照组[(2.08±0.47)L和(1.23±0.22)L],差异均有统计学意义(t值分别为3.62和3.86,P值均<0.05)。结论对哮喘患儿应用吸入用布地奈德混悬液雾化治疗效果确切,可有效调节患儿的T淋巴细胞亚群CD4 ⁺、CD4 ⁺/CD8 ⁺水平,改善肺功能,加速患儿病情的恢复。

关键词: 哮喘, 儿童, 布地奈德, T淋巴细胞亚群, 治疗结果

Abstract:

Objective To explore the clinical effect of inhalation budesonide suspension (Pulmicort Respules) for the treatment of asthma in children.Methods One hundred and seven children with asthma treated in Shenyang 245 Hospital from May 2017 to May 2019 were included as subjects, among which, 52 cases (2 cases were lost to follow-up) in the control group received conventional basic treatment, and 55 cases (3 cases were lost to follow-up) in the experimental group were given inhalation treatment of budesonide suspension combined with conventional treatment. Then the clinical therapeutic effects as well as the changes in CD4 ⁺ T lymphocytes, C-reactive protein (CRP), interleukin-6 (IL-6), forced expiratory volume in 1 second (FEV₁), and forced vital capacity (FVC) levels between the two groups were compared. Results After 7 days of treatment, the total effective rate of the experimental group (96.2%, 50/52) was significantly higher than that of the control group (80.0%, 40/50), with the significant statistical difference (χ ²=4.94, P<0.05). In addition, after 7 days of treatment, the percentage of CD4 ⁺ T lymphocyte in total lymphocyte ((34.32±4.15) %), the ratio of CD4 ⁺/CD8 ⁺ (1.20±0.28), CRP level ((12.38±2.98) mg/L), and IL-6 level ((54.23±6.54) ng/L) in the experimental group were obviously lower than those in the control group ((45.37±3.08) %, 1.67±0.16, (35.82±7.31) mg/L, and (74.24±8.11) ng/L, respectively), all with the significant statistical differences (t=13.35, 9.10, 18.54, and 11.99, respectively, all P<0.05). Furthermore, after 7 days of treatment, the levels of FEV₁ and FVC in the experimental group ((2.41±0.32) L and (1.45±0.28) L) were remarkably higher than those in the control group ((2.08±0.47) L and (1.23±0.22) L), with the significant statistical differences (t=3.62, and 3.86, both P<0.05). Conclusion Inhalation budesonide suspension is effective for the treatment of children with asthma, which can effectively regulate the levels of CD4 ⁺ T lymphocyte and CD4 ⁺/CD8 ⁺ in children with asthma, improve pulmonary function and accelerate the recovery of children’s condition.

Key words: Asthma, Child, Budesonide, T-lymphocytes, Treatment outcome

张红辉,黄威. 吸入用布地奈德混悬液治疗儿童哮喘的临床效果分析[J]. 结核病与肺部健康杂志, 2019, 8(3): 188-191. doi: 10.3969/j.issn.2095-3755.2019.03.008

ZHANG Hong-hui,HUANG Wei.. Clinical effect of inhaled budesonide suspension for the treatment of asthma in children[J]. Journal of Tuberculosis and Lung Health, 2019, 8(3): 188-191. doi: 10.3969/j.issn.2095-3755.2019.03.008

图/表 2

表1

两组患儿T淋巴细胞亚群CD4+、CD8+水平的比较

组别	CD4⁺(%, $x ˉ$ ±s)		CD8⁺(%, $x ˉ$ ±s)		CD4⁺/CD8⁺( $x ˉ$ ±s)
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组(50例)	47.92±2.37	45.37±3.08	21.02±3.81	27.51±2.58	2.41±0.33	1.67±0.16
研究组(52例)	47.96±2.42	34.32±4.15	21.08±3.76	27.99±3.03	2.43±0.38	1.20±0.28
t值	0.07	13.35	0.07	0.75	0.25	9.10
P值	0.474	0.003	0.475	0.265	0.414	0.006

表1

表2

两组患儿血清炎性因子与肺功能指标对比情况

组别	CRP(mg/L, $x ˉ$ ±s)		IL-6(ng/L, $x ˉ$ ±s)		FEV₁(L, $x ˉ$ ±s)		FVC(L, $x ˉ$ ±s)
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组(50例)	43.17±4.82	35.82±7.31	147.62±13.89	74.24±8.11	1.54±0.28	2.08±0.47	1.08±0.12	1.23±0.22
研究组(52例)	42.89±4.96	12.38±2.98	146.58±14.05	54.23±6.54	1.55±0.31	2.41±0.32	1.07±0.11	1.45±0.28
t值	0.25	18.54	0.33	11.99	0.15	3.62	0.38	3.86
P值	0.412	0.001	0.387	0.003	0.447	0.034	0.369	0.031

表2

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