盐酸氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎的疗效评价

发布时间：2018-05-08 03:16

本文选题：盐酸氨溴索 + 阿奇霉素　；参考：《宁波大学》2017年硕士论文

【摘要】：目的:观察分析盐酸氨溴索与阿奇霉素联合应用对于治疗儿童肺炎支原体肺炎的临床疗效及对血清炎性因子、T细胞亚群水平的影响。方法:选取我院2014年9月至2016年9月收住入院的100例儿童肺炎支原体肺炎患儿进行治疗分析,将研究对象随机分为对照组与观察组,每组患儿均为50例。对照组给予单纯阿奇霉素治疗,观察组患儿给予盐酸氨溴索联合阿奇霉素治疗,比较两组患者的治疗效果;比较两组患儿的用力肺活量(FVC)、第1秒最大呼气量(FEV1)、最高呼气流速(PEF);比较两组患儿的退热时间、咳嗽憋喘消失时间、肺部Up音消失时间;比较两组患儿的血清抗炎因子水平IL-6、TNF-α、IL-2、IL-4、IL-10;比较两组患儿的CD4~+、CD8~+、CD4~+/CD8~+;比较两组患者的不良反应。结果:(1)治疗7d后,观察组的治疗总有效率为96.00%(48/50),而对照组的治疗总有效率为80.00%(40/50),观察组的治疗总有效率明显高于对照组(t=6.0606,P=0.01380.05);(2)治疗7d后,两组患儿肺功能指标FVC、FEV1和PEF较治疗前均有显著的提高(P0.05),而观察组的提高幅度要显著大于对照组(P0.05)。治疗7d后,观察组患儿的退热时间为(3.17±0.32)d,咳嗽憋喘消失时间为(7.12±1.16)d,肺部Up音消失时间为(5.42±0.63)d,明显要少于对照组(P0.05),两组比较差异有统计学意义;(3)两组患者治疗前的血清IL-6、TNF-α、IL-2、IL-4、IL-10的检测结果比较无明显差异(P0.05),治疗后两组患者IL-6、TNF-α、IL-4、IL-10均低于治疗前,IL-2显著高于治疗前,差异有显著性(P0.05);治疗后,观察组患者IL-6、TNF-α、IL-4、IL-10均低于对照组,IL-2显著高于对照组,差异有显著性(P0.05)。(4)治疗前两组患者的CD4~+、CD8~+、CD4~+/CD8~+比较,差异无显著性(P0.05);治疗后对照组患者的CD4~+、CD8~+、CD4~+/CD8~+与治疗前比较,差异无显著性(P0.05);治疗后观察组患者的CD4~+、CD8~+、CD4~+/CD8~+显著低于治疗前,差异有显著性(P0.05);治疗后观察组患者的CD4~+、CD8~+、CD4~+/CD8~+显著低于对照组,差异有显著性(P0.05)。结论:(1)盐酸氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎,能显著提高治疗效果。(2)盐酸氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎,能有效改善患儿的肺功能。(3)盐酸氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎,能改善临床症状。(4)盐酸氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎,能降低患者血清炎性因子表达水平。(5)盐酸氨溴索联合阿奇霉素治疗儿童肺炎支原体肺炎,能明显提高因支原体感染而下降的CD4~+、CD8~+、CD4~+/CD8~+水平,从而减弱因免疫失衡、炎症反应过强造成的免疫损伤,无明显不良反应,可作为临床常用治疗方案。
[Abstract]:Aim: to observe the effect of ambroxol hydrochloride combined with azithromycin on the treatment of mycoplasma pneumoniae pneumonia in children and on the level of serum inflammatory factor T cell subsets. Methods: 100 children with mycoplasma pneumoniae pneumonia admitted in our hospital from September 2014 to September 2016 were selected and analyzed. The subjects were randomly divided into control group and observation group, 50 cases in each group. The patients in the control group were treated with azithromycin alone, and the children in the observation group were treated with ambroxol hydrochloride combined with azithromycin. The forced vital capacity (VV) of the two groups was compared, the maximal expiratory volume in the first second (FEV1) and the maximum expiratory flow rate (PEF) in the two groups were compared, and the antipyretic time, the time of cough and asthma disappearance, and the time of disappearance of pulmonary up sound were compared between the two groups. The levels of serum anti-inflammatory factor (IL-6TNF- 伪) and IL-4 / IL-10 were compared between the two groups, and the levels of CD4 ~ + CD8 ~ / CD4 ~ / CD8 ~, and the adverse reactions of the two groups were compared. Results after 7 days of treatment, the total effective rate of the observation group was 96.00 / 48 / 50, while that of the control group was 80.0040 / 50. The total effective rate of the observation group was significantly higher than that of the control group (6.0606) (0.01380.05) after 7 days of treatment, the total effective rate of the observation group was significantly higher than that of the control group (0.01380.05) after 7 days of treatment, the total effective rate of the observation group was significantly higher than that of the control group. The pulmonary function indexes (FVC, FEV1 and PEF) of the two groups were significantly higher than those of the control group (P 0.05), and the improvement range of the observation group was higher than that of the control group (P 0.05). After 7 days of treatment, The antipyretic time of the observation group was 3.17 卤0.32 days, the time of cough and asthma disappearance was 7.12 卤1.16 days, the time of disappearance of pulmonary up was 5.42 卤0.63 days, which was significantly lower than that of the control group (P 0.05). The difference between the two groups was statistically significant. There was no significant difference between the two groups (P 0.05). After treatment, IL-6 TNF- 伪 IL-4 IL-10 was significantly lower than that before treatment and IL-2 was significantly higher than that before treatment. After treatment, the level of IL-6 TNF- 伪 IL-4 IL-10 in the observation group was significantly lower than that in the control group, and the difference was significant between the two groups before treatment. After treatment, there was no significant difference between the control group and the pre-treatment group, but there was no significant difference between the control group and the control group before and after treatment, the CD4 ~ + CD8- / CD8- / CD8-% of the patients in the observation group was significantly lower than that of the control group before and after treatment, and there was no significant difference between the control group and the control group before treatment, and there was no significant difference between the two groups after treatment. After treatment, the patients in the observation group were significantly lower than those in the control group (P 0.05). Conclusion ambroxol hydrochloride combined with azithromycin can significantly improve the therapeutic effect of mycoplasma pneumoniae pneumonia in children. Ambroxol hydrochloride combined with azithromycin can effectively improve the pulmonary function of children with mycoplasma pneumoniae pneumonia, and can improve the clinical symptoms of children with mycoplasma pneumoniae pneumonia treated by ambroxol hydrochloride combined with azithromycin. Azithromycin hydrochloride combined with ambroxol hydrochloride in the treatment of mycoplasma pneumoniae pneumonia in children, can obviously increase the level of CD4 ~ + CD8 ~ + CD4 ~ / CD8- / CD8-, which can weaken the imbalance of immune system, which can decrease the expression level of serum inflammatory factors in patients with mycoplasma pneumoniae. The immune injury caused by the overreaction of inflammation has no obvious adverse reaction and can be used as a common therapy in clinic.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.6

【相似文献】