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目的分析雾化吸入高剂量布地奈德对重度哮喘患儿血清细胞因子水平的影响及疗效。方法选取我院2013年7月-2016年10月收治的66例重度哮喘患儿,采用随机数字表法分为观察组(33例)和对照组(33例)。两组均在常规综合治疗基础上加用雾化吸入布地奈德治疗,观察组给药剂量为1.0 mg/次,对照组给药剂量为0.5mg/次,治疗7 d后统计两组总有效率、不良反应发生率,并对比两组治疗前和治疗7 d后血清细胞因子[中性粒细胞过氧化物酶(MPO)、白介素-2(IL-2)、白介素-4(IL-4)、白介素-8(IL-8)、白介素-17(IL-17)]、肺功能指标[第1 s呼吸气体容积与用力肺活量比值(FEV1.0/FVC)、呼气峰流速(PEF)]水平。结果⑴疗效:治疗7 d后观察组总有效率90.91%(30/33)高于对照组66.67%(22/33),差异具有统计学意义(P<0.05)。⑵血清细胞因子水平:治疗7d后观察组IL-2高于对照组,MPO、IL-4、IL-8、IL-17低于对照组,差异均有统计学意义(P<0.05)。⑶肺功能:与治疗前相比,两组治疗7 d后FEV1.0/FVC、PEF均升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。⑷安全性:观察组不良反应发生率9.09%(3/33)与对照组3.03%(1/33)相比,差异无统计学意义(P>0.05)。结论雾化吸入高剂量布地奈德治疗重度哮喘疗效较佳,可改善患儿血清细胞因子水平,且不会增加不良反应发生率。
Objective To analyze the effects of inhaled high dose budesonide on serum cytokines in children with severe asthma and its therapeutic effect. Methods Sixty-six children with severe asthma admitted to our hospital from July 2013 to October 2016 were randomly divided into observation group (33 cases) and control group (33 cases). Both groups were treated with inhaled budesonide on the basis of conventional comprehensive treatment. The dosage of the observation group was 1.0 mg / time, the dosage of the control group was 0.5 mg / time. After 7 days of treatment, Efficiency and incidence of adverse reactions. The levels of serum cytokines (MPO, IL-2, IL-4 (IL-8, IL-17), pulmonary function index (FEV1.0 / FVC), peak expiratory flow (PEF) ]Level. Results (1) Efficacy: The total effective rate in observation group was 90.91% (30/33) after 7 days of treatment, which was significantly higher than 66.67% (22/33) in control group (P <0.05). (2) The level of serum cytokines: The level of IL-2 in the observation group after 7 days of treatment was higher than that in the control group, and the levels of MPO, IL-4, IL-8 and IL-17 in the observation group were lower than those in the control group (P <0.05). (3) Pulmonary function: Compared with that before treatment, FEV1.0 / FVC and PEF in both groups increased 7 days after treatment, and the observation group was higher than the control group, the difference was statistically significant (P <0.05). ⑷ Safety: The incidence of adverse reactions in the observation group was 9.09% (3/33) compared with 3.03% (1/33) in the control group, with no significant difference (P> 0.05). Conclusion Inhalation of high dose budesonide for the treatment of severe asthma is better, which can improve the level of serum cytokines in children without increasing the incidence of adverse reactions.