阿法骨化醇辅助治疗小儿毛细支气管炎的临床观察

发布时间：2018-11-07 20:17

【摘要】：目的:观察阿法骨化醇辅助治疗小儿毛细支气管炎的临床疗效和安全性。方法:回顾性分析156例毛细支气管炎患儿资料,按照用药不同分为观察组(78例)和对照组(78例)。所有患儿入院后均接受吸氧、平喘、抗病毒等常规治疗,在此基础上对照组患儿给予布地奈德混悬液0.5~1.0 mg+沙丁胺醇气雾剂0.25 m L,雾化吸入,bid,每次吸入10 min,连续治疗7 d。观察组患儿在对照组治疗基础上加服阿法骨化醇软胶囊0.010~0.015μg/(kg·d),每周3次,连续治疗3个月。观察并比较两组患儿临床疗效,临床症状及体征改善时间,治疗前后血清维生素D[25-(OH)D_3]、血清瘦素(LEP)、免疫球蛋白(Ig)A、Ig G、Ig M、Ig E水平和不良反应发生情况。结果:治疗7 d后观察组患儿总有效率显著高于对照组,咳嗽、喘息缓解时间,哮鸣音及湿Up音消失时间显著短于对照组,差异均有统计学意义(P0.05);治疗3个月后,两组患儿25-(OH)D_3、Ig A、Ig G水平显著高于同组治疗前,且观察组显著高于对照组;两组患儿LEP、Ig E水平显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P0.05)。两组患儿治疗前后Ig M水平比较差异无统计学意义(P0.05)。两组患儿治疗过程中均未见明显药物相关的不良反应发生。结论:在常规治疗基础上,阿法骨化醇辅助治疗小儿毛细支气管炎疗效较好,可以明显增强患儿免疫功能,降低血清LEP水平,进而缩短患儿临床症状及体征缓解时间,且不增加不良反应的发生,安全性较好。
[Abstract]:Objective: to observe the efficacy and safety of alfacalciol in the treatment of bronchiolitis in children. Methods: 156 children with bronchiolitis were retrospectively analyzed and divided into observation group (78 cases) and control group (78 cases). All the children received routine treatment such as oxygen inhalation, antiasthmatic and antiviral therapy after admission. On this basis, the control group was given budesonide suspension 0.51.0 mg salbutamol aerosol 0.25 mL, nebulized inhalation, bid, inhalation for 10 min, each time. Continuous treatment for 7 days. On the basis of treatment in control group, the children in the observation group were treated with Alfacalidol soft capsule 0.010 0 15 渭 g / (kg d), 3 times a week for 3 months. To observe and compare the clinical curative effect, the time of improvement of clinical symptoms and signs, the serum vitamin D [25 (OH) D3], the serum leptin (LEP), immunoglobulin (Ig) Ag G M before and after treatment in the two groups. The level of Ig E and the occurrence of adverse reactions. Results: the total effective rate of the observation group was significantly higher than that of the control group after 7 days of treatment. The time of cough, gasping remission, wheezing and wet Up were significantly shorter than that of the control group (P0.05). After 3 months of treatment, the level of 25 (OH) D 3G Ig G in the two groups was significantly higher than that in the same group before treatment, and that in the observation group was significantly higher than that in the control group. The level of LEP,Ig E in the two groups was significantly lower than that in the same group before treatment, and that in the observation group was significantly lower than that in the control group (P0.05). There was no significant difference in Ig M levels between the two groups before and after treatment (P0.05). There were no obvious adverse drug-related reactions in both groups. Conclusion: on the basis of routine treatment, Alfacalciol is effective in the treatment of pediatric bronchiolitis, which can significantly enhance the immune function, decrease the level of serum LEP, and shorten the time of remission of clinical symptoms and signs in children with bronchiolitis. And the safety is good without increasing the occurrence of adverse reactions.
【作者单位】：海南省人民医院儿科;海南医学院附属医院内分泌科;
【分类号】：R725.6

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