[1]秦小菀,高伟霞.阿奇霉素联合甲泼尼龙治疗儿童难治性支气管哮喘疗效观察[J].新乡医学院学报,2019,36(11):1070-1073.[doi:10.7683/xxyxyxb.2019.11.015]
　QIN Xiao-wan,GAO Wei-xia.Effect of azithromycin combined with methylprednisolone in the treatment of refractory bronchial asthma in children[J].Journal of Xinxiang Medical University,2019,36(11):1070-1073.[doi:10.7683/xxyxyxb.2019.11.015]
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阿奇霉素联合甲泼尼龙治疗儿童难治性支气管哮喘疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年11
页码:
1070-1073
栏目:
临床研究
出版日期:
2019-11-05

文章信息/Info

Title:
Effect of azithromycin combined with methylprednisolone in the treatment of refractory bronchial asthma in children
作者:
秦小菀; 高伟霞
（南阳市中心医院儿科，河南　南阳　473000）
Author(s):
QIN Xiao-wan; GAO Wei-xia
(Department of Pediatrics，Nanyang Central Hospital，Nanyang 473000，Henan Province，China)
关键词:
难治性支气管哮喘; 阿奇霉素; 甲泼尼龙; 哮喘控制测试
Keywords:
refractory bronchial asthma; azithromycin; methylprednisolone; asthma control test
分类号:
R562.2+5
DOI:
10.7683/xxyxyxb.2019.11.015
文献标志码:
A
摘要:
目的　探讨阿奇霉素与甲泼尼龙联合治疗儿童难治性支气管哮喘的临床效果。方法　选择2013年4月至2016年4月南阳市中心医院收治的120例难治性支气管哮喘患儿为研究对象，根据治疗方法分为观察组和对照组，每组60例。2组患儿均给予抗炎、解痉平喘等常规治疗；在常规治疗基础上，对照组患儿给予甲泼尼龙治疗；观察组患儿给予甲泼尼龙和阿奇霉素联合治疗，2组患儿均7 d为1个疗程，共治疗3个疗程。分别于治疗前和治疗后检测2组患儿血清白细胞介素-4（IL-4）、白细胞介素-5（IL-5）、γ-干扰素（IFN-γ)水平及嗜酸性粒细胞和中性粒细胞计数，并进行肺功能检测，记录用力肺活量（FVC）、第1秒用力呼气量（FEV1）及FEV1/FVC。分别于治疗前及治疗后对2组患儿进行哮喘控制测试（ACT）评分，并进行临床疗效评估；治疗期间观察2组患儿不良反应发生情况。结果　治疗前2组患儿血清IL-4、IL-5、IFN-γ水平及嗜酸性粒细胞和中性粒细胞计数比较差异均无统计学意义（P>0.05），2组患儿治疗后血清IL-4、IL-5、IFN-γ水平及嗜酸性粒细胞和中性粒细胞计数显著低于治疗前（P<0.05）；治疗后，观察组患儿血清IL-4、IL-5、IFN-γ水平及嗜酸性粒细胞和中性粒细胞计数显著低于对照组（P<0.05）。治疗前2组患儿ACT评分、FVC 、FEV1及FEV1/FVC比较差异均无统计学意义（P>0.05）；2组患儿治疗后ACT评分、FVC 、FEV1及FEV1/FVC显著高于治疗前（P<0.05）；治疗后，观察组患儿ACT评分、FVC 、FEV1及FEV1/FVC显著高于对照组（P<0.05）。观察组和对照组患儿治疗总有效率分别为91.67%（55/60）、78.33%（47/60），观察组患儿治疗总有效率高于对照组（χ2=2.258，P<0.05）。观察组和对照组患儿不良反应发生率分别为4.83%（2/60）、1.67%（1/60），2组患儿不良反应发生率比较差异无统计学意义（χ2=1.035，P>0.05）。结论　阿奇霉素和甲泼尼龙联合治疗可有效抑制难治性支气管哮喘患儿炎症反应，显著改善患儿临床症状，且无严重不良反应。
Abstract:
Objective　To investigate the clinical effect of azithromycin combined with methylprednisolone in the treatment of refractory bronchial asthma in children.Methods　A total of 120 children with refractory bronchial asthma admitted to Nanyang Central Hospital from April 2013 to April 2016 were selected as the study objects.The children were divided into observation group and control group according to the treatment methods，with 60 cases in each group.The children in the two groups were given routine treatment such as anti-inflammation，spasmolysis and antiasthma.On the basis of routine treatment，the children in the control group were treated with methylprednisolone，while the children in the observation group were treated with methylprednisolone and azithromycin.The children in the two groups were treated for three courses of treatment，and seven days was a course of treatment.The levels of serum interleukin-4 (IL-4)，interleukin-5 (IL-5)，interferon-γ (IFN-γ) and eosinophil and neutrophil counts were measured before and after treatment.The lung function of children in the two groups were detected，and the forced vital capacity (FVC)，forced expiratory volume in one second (FEV1) and FEV1 / FVC were recorded.The children in the two groups were evaluate by the asthma control test (ACT) before and after treatment，and the clinical effect was evaluated.The adverse reactions of children in the two groups were observed during the treatment.Results　There was no significant difference in the levels of serum IL-4，IL-5，IFN-γ，eosinophils and neutrophils count between the two groups before treatment (P>0.05).The levels of serum IL-4，IL-5，IFN-γ and the counts of eosinophils and neutrophils after treatment were significantly lower than those before treatment in the two groups (P<0.05).The levels of serum IL-4，IL-5，IFN-γ and the counts of eosinophils and neutrophils in the observation group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the ACT score，FVC，FEV1 and FEV1/FVC between the two groups before treatment (P>0.05).The ACT score，FVC，FEV1 and FEV1/FVC after treatment were significantly higher than those before treatment in the two groups (P<0.05).The ACT score，FVC，FEV1 and FEV1/FVC in the observation group were significantly higher than those in the control group after treatment (P<0.05).The total effective rate in the observation group and the control group was 91.67% (55/60) and 78.33% (47/60)，respectively.The total effective rate in the observation group was higher than that in the control group (χ2=2.258，P<0.05).The incidence of adverse reactions in the observation group and the control group was 4.83% (2/60) and 1.67% (1/60)，respectively.There was no significant difference between the two groups (χ2=1.035，P>0.05).Conclusion　Azithromycin combined with methylprednisolone can effectively inhibit inflammation and significantly improve the clinical symptoms of children with refractory bronchial asthma，and there is no serious adverse reaction.

参考文献/References:

［1］　赵茜叶，赵德育.儿童难治性哮喘的识别与处理［J］.中华实用儿科临床杂志，2018，33（16）：1204-1207.
［2］　卢春亚，张国俊.难治性哮喘的研究新进展［J］.河南医学研究，2016，25（4）：656-658.
［3］　吴迪.支气管哮喘治疗现状及进展［J］.医学综述，2013，19（4）：664-667.
［4］　徐锋，韩纪昌，张雅军，等.阿奇霉素对难治性哮喘患儿肺功能及气道炎症的疗效观察［J］.中国现代药物应用，2016，10（16）：153-153，154.
［5］　中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南［J］.中华结核和呼吸杂志，2008，31（3）：177-189.
［6］　杨一民，曾谷兰，李雅心，等.儿童支气管哮喘控制测试的临床应用［J］.中华实用儿科临床杂志，2017，32（16）：1248-1252.
［7］　中华医学会儿科学分会呼吸学组，中华儿科杂志编辑委员会.儿童支气管哮喘诊断与防治指南［J］.中华儿科杂志，2008，46（10）：745-750.
［8］　吉宁飞，黄茂.难治性哮喘的定义、表型与治疗进展［J］.国际呼吸杂志，2013，33（23）：1805-1808.
［9］　向莉.全球哮喘防治创议（GINA)2018更新版要点导读与解析［J］.中华实用儿科临床杂志，2018，33（11）：807-811.
［10］　PRASAD B N.Refractory asthma: an old disorder: novel approaches for effective control［J］.Med J Armed Forces India，2016,72(3):277-280.
［11］　MENZELLA F，LUSUARDI M，GALEONE C，et al.Mepolizumab for severe refractory eosinophilic asthma: evidence to date and clinical potential［J］.Ther Adv Chronic Dis，2016,7(6):260-277.
［12］　ASGHARZADEH M，GHORGHANLU S，RASHEDI J，et al.Association of promoter polymorphisms of interleukin-10 and interferon-gamma genes with tuberculosis in Azeri population of Iran［J］.Iran J Allergy Asthma Immunol，2016，15(3):167-73.
［13］　蒋曼.阿奇霉素治疗支气管哮喘患儿的疗效及对外周血辅助性T淋巴细胞功能的影响［J］.临床合理用药杂志，2015，8（33）：49-50.

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更新日期/Last Update: 2019-11-05