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目的观察雾化吸入沙丁胺醇治疗小儿哮喘的临床疗效及对患儿肺功能、血清嗜酸性粒细胞(EOS)、免疫球蛋白E(Ig E)的影响。方法将160例患儿随机分为试验组和对照组,各80例。对照组患儿雾化吸入布地奈德混悬液1.0mg,每次5 min,每天2次;试验组在对照组治疗之前给予沙丁胺醇溶液2.5 mg,每次5 min,每天2次,雾化吸入。2组患儿均治疗2周。比较2组患儿治疗前后及治疗后3个月的肺功能变化,观察治疗前后2组EOS、Ig E水平。结果治疗后,试验组总有效率为98.68%(75/76例),对照组为84.13%(53/63例),差异有统计学意义(P<0.05)。治疗后3个月,试验组和对照组用力肺活量(FVC)分别为(79.34±6.52),(70.20±3.34)L;第1秒用力通气量为(FEV1)分别为(80.12±3.32),(68.25±2.90)L;峰值呼气流速(PEF)分别为(82.08±9.62),(71.21±4.52)L·min-1;肺活量(VC)分别为(83.42±4.10),(73.17±2.34)L,差异均有统计学意义(均P<0.05)。试验组和对照组外周血EOS绝对值分别为(0.52±0.13)×109/L,(0.96±0.23)×109/L;血清Ig E水平分别为(105.32±62.35),(222.58±84.71)ng·m L-1,差异均有统计学意义(均P<0.05)。对照组出现恶心1例(1.59%),试验组出现声嘶2例(2.63%),2组均未出现药物过敏、院内感染、皮疹等药物不良反应,2组药物不良反应发生率差异无统计学意义(P>0.05)。结论糖皮质激素联合沙丁胺醇雾化吸入对小儿哮喘的临床疗效显著,且能明显降低血液EOS和Ig E水平,改善肺功能状态。
Objective To observe the clinical efficacy of nebulized albuterol inhalation in children with asthma and its effects on pulmonary function, serum eosinophil (EOS) and immunoglobulin E (IgE) in children. Methods 160 cases of children were randomly divided into experimental group and control group, 80 cases each. In the control group, 1.0 mg budesonide suspension was nebulized by inhalation for 5 min every time for 5 min. In the control group, 2.5 mg salbutamol solution was given for 5 min prior to treatment in the control group, . Two groups of children were treated for 2 weeks. The changes of pulmonary function in two groups before and after treatment and after 3 months of treatment were compared, and the levels of EOS and Ig E in two groups before and after treatment were observed. Results After treatment, the total effective rate was 98.68% (75/76) in the experimental group and 84.13% (53/63 cases) in the control group, the difference was statistically significant (P <0.05). Three months after the treatment, the forced vital capacity (FVC) of the test group and the control group were (79.34 ± 6.52) and (70.20 ± 3.34) L, respectively, and the FEV1 values were (80.12 ± 3.32) and 68.25 ± 2.90) L, peak expiratory flow rate (PEF) were (82.08 ± 9.62) and (71.21 ± 4.52) L · min-1, respectively. The vital capacity of VC was (83.42 ± 4.10) and , The differences were statistically significant (all P <0.05). The absolute values of EOS in the peripheral blood of the experimental group and the control group were (0.52 ± 0.13) × 109 / L and (0.96 ± 0.23) × 109 / L respectively, and the serum IgE levels were (105.32 ± 62.35) and (222.58 ± 84.71) ng · M L-1, the differences were statistically significant (all P <0.05). In the control group, nausea occurred in 1 case (1.59%), and in the experimental group, hoarseness was found in 2 cases (2.63%). No drug allergy, nosocomial infection, skin rash and other adverse drug reactions occurred in the two groups. There was no statistical difference in adverse reactions between the two groups Significance (P> 0.05). Conclusion The clinical effect of inhalation of glucocorticoid combined with salbutamol on pediatric asthma is significant, and the level of EOS and Ig E in blood can be obviously decreased and the pulmonary function status can be improved.