摘要
目的 探讨乙酰半胱氨酸辅助治疗重症支气管肺炎患儿的疗效及对潮气呼吸肺功能、免疫功能的改善作用.方法 选取西华县人民医院重症支气管肺炎患儿90例(2021年1月至2023年8月),按照随机数字表法分为试验组(45例)和常规组(45 例).常规组给予阿奇霉素,试验组给予阿奇霉素联合乙酰半胱氨酸.比较两组临床疗效、症状消失时间、潮气呼吸肺功能[潮气量(VT/kg)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)]、免疫功能(CD3+、CD4+、CD4+/CD8+)、炎症指标[白介素 1 受体 1 型(IL-1R1)、活化蛋白C(APC)]及不良反应.结果 试验组治疗有效率 88.89%高于常规组 71.11%,差异有统计学意义(P＜0.05);试验组发热、咳嗽、气促及肺部啰音消失时间短于常规组,差异有统计学意义(P＜0.05);与治疗前相比,两组治疗 7 d后VPEF/VE、TPTEF/TE、VT/kg均明显升高,试验组高于常规组,差异有统计学意义(P＜0.05);与常规组相比,观察组治疗 7 d后CD3+、CD4+、CD4+/CD8+均明显升高,差异有统计学意义(P＜0.05);试验组治疗 7 d后血清IL-1R1 水平低于常规组,APC高于常规组,差异有统计学意义(P＜0.05);治疗期间,试验组不良反应发生率(11.11%)与常规组(6.67%)相比,差异无统计学意义(P＞0.05).结论 乙酰半胱氨酸联合阿奇霉素能调节重症支气管肺炎患儿免疫失衡,减轻炎症,有效缓解病情,改善潮气呼吸肺功能,增强疗效.
Abstract
Objective To investigate the effect of acetylcysteine in the adjuvant treatment of severe bronchopneumonia in children and the improvement of lung function and immune function in damp respiration.Methods A total of 90 children with severe bronchopneumonia(January 2021 to August 2023)were selected from Xihua County People's Hospital and divided into an experimental group(45 cases)and a routine group(45 cases)according to the random number table method.The conventional group was given azithromycin,and the experimental group was given azithromycin combined with acetylcysteine.The clinical efficacy,symptom disappearance time,tidal breathing pulmonary function[tidal volume(VT/kg),peak time ratio(TPTEF/TE),peak volume ratio(VPEF/VE)],immune function(CD3+,CD4+,CD4+/CD8+),inflammatory indexes[interleukin-1 receptor type 1(IL-1R1),activated protein C(APC)]and adverse reactions were compared between the two groups.Results The treatment effective rate of the experimental group was 88.89%higher than that of the conventional group(71.11%),the difference was statistically significant(P＜0.05).The disappearance time of fever,cough,shortness of breath,and lung rales in experimental groups was shorter than that in the conventional group,and the difference was statistically significant(P＜0.05).Compared with before treatment,VPEF/VE,TPTEF/TE,and VT/kg in the two groups were significantly increased after 7 days of treatment,and those in the experimental group were higher than those in the conventional group,and the differences were statistically significant(P＜0.05).Compared with the conventional group,CD3+,CD4+,CD4+/CD8+ were significantly increased in the observation group after 7 days of treatment,with statistical significance(P＜0.05).After 7 days of treatment,the serum IL-1R1 level of the experimental group was lower than that of the conventional group,and APC was higher than that of the conventional group,the difference was statistically significant(P＜0.05).During treatment,the incidence of adverse reactions in the experimental group was 11.11%compared with 6.67%in the conventional group,and the difference was statistically significant(P＞0.05).Conclusion Acetylcysteine combined with azithromycin can regulate the immune imbalance,reduce inflammation,effectively relieve the disease,improve moist respiratory lung function,and enhance the therapeutic effect in children with severe bronchopneumonia.
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维普
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