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目的:探讨布地奈德联合孟鲁司特钠治疗肺炎支原体肺炎(MPP)患儿的疗效及其对患儿肺功能和炎性细胞因子的影响。方法:选取2016年1-4月我院儿科收治的MPP患儿106例,随机分为观察组和对照组各53例。两组患儿入院后均给予祛痰、平喘、抗感染等常规治疗,对照组患儿同时给予布地奈德治疗,观察组患儿在对照组治疗基础上联用孟鲁司特钠,疗程均为10 d。治疗前后采用酶联免疫吸附法(ELISA)检测血清白细胞介素(IL)-6、IL-8、IL-10及肿瘤坏死因子-α(TNF-α)水平,采用肺功能监测仪检测潮气量(VT)、达峰时间比(TPTEF/TE)、呼出25%潮气量时的瞬间流速与呼气峰流速比(TEF25/PTEF)。比较两组总有效率及不良反应发生率。结果:治疗后,两组患儿IL-6、IL-8、TNF-α水平均降低,IL-10水平均升高,VT、TPTEF/TE、TEF25/PTEF均明显改善,且治疗时间越长改善越明显(P均<0.05),观察组患儿改善程度均优于对照组(P均<0.05)。观察组总有效率92.45%,高于对照组的81.13%(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:布地奈德联合孟鲁司特钠可有效改善MPP患儿的肺功能,降低血清炎性细胞因子水平,提高临床疗效,且不会增加不良反应,安全性较好。
Objective: To investigate the efficacy of budesonide combined with montelukast sodium in children with Mycoplasma pneumoniae pneumonia (MPP) and its effect on pulmonary function and inflammatory cytokines in children. Methods: A total of 106 children with MPP admitted to our hospital from January to April in 2016 were randomly divided into observation group (53 cases) and control group (53 cases). Two groups of children were given expectorant, antiasthmatic, anti-infective and other conventional treatment after admission, the control group of children given budesonide treatment, the observation group of children in the control group based on the combination of montelukast sodium, treatment All 10 d. Serum interleukin (IL) -6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α) levels were measured by enzyme-linked immunosorbent assay (ELISA) before and after treatment. Tidal volume (TEF25 / PTEF) at peak tidal time (TPTEF / TE), exhaled 25% tidal volume. The total effective rate and incidence of adverse reactions in both groups were compared. Results: After treatment, the levels of IL-6, IL-8 and TNF-α in both groups were decreased, the levels of IL-10 were increased, VT, TPTEF / TE and TEF25 / PTEF were significantly improved and the treatment time was longer (P <0.05). The improvement in the observation group was better than that in the control group (all P <0.05). The total effective rate in the observation group was 92.45%, which was higher than that in the control group (81.13%, P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: Budesonide combined with montelukast sodium can effectively improve the pulmonary function of MPP children, reduce serum levels of inflammatory cytokines, improve clinical efficacy, and will not increase adverse reactions, safety is better.