异丙托溴铵辅助治疗小儿急性发作期支气管哮喘的效果及对肺功能和机体炎性因子的影响

连鹏强 安妮 曾志涌

【摘要】 目的：分析異丙托溴铵辅助治疗小儿急性发作期支气管哮喘的效果及对肺功能和机体炎性因子的影响。方法：选取2016年7月-2017年11月本院收治的82例支气管哮喘患儿为研究对象。按照随机数字表法将其分为试验组和对照组，各41例。对照组雾化吸入布地奈德，试验组在此基础上加用雾化吸入异丙托溴铵。比较两组症状及体征消退时间、疗效、肺功能（PEF、FEV1、FVC、FEV1/FVC）和机体炎性因子（IL-5、IL-13、TNF-α）等变化情况。结果：试验组咳嗽、气喘、呼吸困难、哮鸣音消退时间均短于对照组，差异均有统计学意义（P<0.05）;试验组总有效率为92.68%，明显高于对照组75.61%（P<0.05）;治疗1周后，试验组PEF、FEV1、FVC、FEV1/FVC均高于对照组（P<0.05）;治疗1周后，两组IL-5、IL-13比较，差异均无统计学意义（P>0.05），但试验组TNF-α低于对照组（P<0.05）。结论：异丙托溴铵辅助治疗小儿急性发作期支气管哮喘的效果较好，对肺功能改善较为明显，同时对机体炎性因子有一定影响，可以在一定程度上帮助改善患儿症状，提高临床疗效。

【关键词】 儿童支气管哮喘; 急性发作期; 异丙托溴铵; 布地奈德

【Abstract】 Objective：To observe the effect of Ipratropium Bromide in the adjuvant treatment of bronchial asthma in children with acute attack and its effect on lung function and inflammatory factors.Method：A total of 82 children with bronchial asthma admitted to our hospital from July 2016 to November 2017 were selected as the study subjects.According to the random number table method，they were divided into experimental group and control group，41 cases in each group.The control group was inhaled Budesonide by atomization，and experimental group was inhaled Ipratropium Bromide by atomization.The symptoms and signs subsidence time，curative effect，pulmonary function（PEF，FEV1，FVC，FEV1/FVC）and body inflammatory factors（IL-5，IL-13，TNF-α）between two groups were compared.Result：The cough，asthma，dyspnea and wheezing subsidence time of experimental group were shorter than those of control group，the differences were statistically significant（P<0.05）.The total effective rate of experimental group was 92.68%，which was significantly higher than 75.61% of control group（P<0.05）.1 week after treatment，PEF，FEV1，FVC and FEV1/FVC in experimental group were higher than those of control group（P<0.05）.1 week after treatment，IL-5 and IL-13 in two groups were compared，the differences were not statistically significant（P>0.05），but TNF-αin experimental group was lower than that of control group（P<0.05）.Conclusion：Ipratropium Bromide has a better effect in the adjuvant treatment of children with acute attack of bronchial asthma，it can improve the lung function and inflammatory factors，can help to improve the symptoms of children and improve the clinical efficacy to a certain extent.

【Key words】 Bronchial asthma in children; Acute attack; Ipratropium Bromide; BudesonideFirst-authors address：The Second Peoples Hospital of Longgang District，Shenzhen 518112，China

doi：10.3969/j.issn.1674-4985.2019.15.010

小儿支气管哮喘作为一种在临床上较为常见的儿科呼吸系统疾病，常反复发作，难以治愈，一旦急性发作可造成患儿胸闷、气促、喘息、呼吸困难等临床症状短时间内急剧加重，如不能及时有效救治将会危及患儿生命[1-3]。异丙托溴铵作为一种临床上常用的抗胆碱能药物，在辅助治疗哮喘急性发作上虽已有应用，但是其对于症状控制和治疗效果等方面的相关研究仍不充分。本研究拟通过观察对比异丙托溴铵辅助治疗小儿急性发作期支气管哮喘的效果及对肺功能和机体炎性因子的影响，旨在为临床用药提供指导帮助。……