目的 观察不同剂量硫酸沙丁胺醇雾化吸入溶液雾化治疗儿童支气管哮喘急性发作的临床疗效。方法 选择2018年1月-2020年1月于安阳市第二人民医院就诊的120例支气管哮喘急性发作患儿，采用随机数字表法将所有患儿分为低、中、高剂量组，每组各40例。取硫酸沙丁胺醇雾化吸入溶液适量加生理盐水混合，使用雾化器吸入，低、中、高剂量组患儿分别每次2、3、4 mL。3组患儿均持续治疗7 d。观察3组的临床疗效，比较3组的炎症因子、免疫功能指标。结果 治疗后，中剂量组患儿的总有效率（97.50%）显著高于低剂量组（85.00%）和高剂量组（75.00%），组间比较差异具有统计学意义（P<0.05）。治疗后，3组血清白细胞介素-6（IL-6）、血清生长因子β₁（TGF-β₁）、C反应蛋白（CRP）、血小板压积（PCT）水平均明显下降（P<0.05），并且中剂量组血清IL-6、TGF-β₁、CRP、PCT水平明显低于低剂量组和高剂量组（P<0.05）。治疗后，3组血清表面抗原分化簇3受体（CD3⁺）、表面抗原分化簇4受体（CD4⁺）水平上升，表面抗原分化簇8受体（CD8⁺）水平下降（P<0.05）；中剂量组血清CD3⁺、CD4⁺水平高于低剂量组和高剂量组，CD8⁺水平低于低剂量组和高剂量组（P<0.05）。结论 不同剂量沙丁胺醇雾化吸入能有效治疗儿童支气管哮喘急性发作，改善患儿气道炎症，增强免疫功能，并且中剂量沙丁胺醇雾化吸入疗效较好，不良反应发生率较低。

Objective To observe the clinical efficacy of different doses of salbutamol atomization in treatment of acute attack of bronchial asthma in children. Methods Children (120 cases) with acute attack of bronchial asthma in children in the Second People's Hospital of Anyang from January 2018 to January 2020 were randomly divided into low, medium and high dose groups, and each group had 40 cases. Salbutamol Sulfate Nebules Inhalation Solution was mixed with normal saline, and inhaled with nebulizer, the children in low-dose, medium-dose and high-dose groups were given 2, 3, and 4 mL, respectively. Patients in three groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the inflammatory factor index and the immune function index in three groups were compared. Results After treatment, the total effective rate of middle-dose group (97.50%) was significantly higher than that of low-dose group (85.00%) and high-dose group (75.00%), and the difference was statistically significant (P<0.05). After treatment, the serum levels of IL-6, TGF-β₁, CRP, and PCT in three groups were significantly decreased (P<0.05), and the serum levels of IL-6, TGF-β₁, CRP, and PCT in middle-dose group were significantly lower than those in low-dose group and high-dose group (P<0.05). After treatment, the serum levels of CD3⁺ and CD4⁺ in three groups were increased, but the serum levels of CD8⁺ in three groups were decreased (P<0.05). The serum levels of CD3⁺ and CD4⁺ in middle-dose group were higher than those in low-dose group and high-dose group, while the serum levels of CD8⁺ in middle-dose group was lower than those in low-dose group and high-dose group (P<0.05). Conclusion Different doses of Salbutamol atomization inhalation has good clinical efficacy in the treatment of acute attack of bronchial asthma in children, which can effectively reduce the inflammatory reaction of children and enhance the immune function. Middle-dose salbutamol aerosol inhalation has better curative effect and lower incidence of adverse reactions.

R974