目的 探讨小儿喘息性疾病应用注射用乳糖酸红霉素联合硫酸沙丁胺醇雾化吸入溶液治疗的临床效果。方法 选取2017年3月—2019年7月辽宁省朝阳市第二医院收治的102例喘息性疾病患儿，运用随机数字表法将其随机分成观察组（n=51）和对照组（n=51）。其中对照组采取硫酸沙丁胺醇雾化吸入溶液氧气驱动雾化吸入治疗，年龄<5岁者，2.5 mg/次，3次/d；≥5岁者，5 mg/次，3次/d。观察组在对照组基础上静脉滴注注射用乳糖酸红霉素治疗，30 mg/（kg·d）加入生理盐水中充分稀释，1次/d。所有患儿均治疗7 d。比较两组临床疗效及主要临床症状改善时间，治疗前后的白细胞介素-4（IL-4）、Clara细胞分泌蛋白（CCSP）、C反应蛋白（CRP）、呼出气一氧化氮（FeNO）水平变化。结果 治疗后，观察组总有效率为94.1%，较对照组的80.4%显著提高（P<0.05）。治疗后，观察组临床症状（喘息、咳嗽、气促、哮鸣音等）的改善时间均显著短于对照组（P<0.05）。与治疗前相比，两组治疗后FeNO浓度及血清IL-4、CRP水平均显著降低（P<0.05），血清CCSP水平则均显著增高（P<0.05）；且治疗后，观察组FeNO浓度和血清IL-4、CRP水平均显著低于对照组（P<0.05），而血清CCSP水平显著高于对照组（P<0.05）。结论 应用注射用乳糖酸红霉素联合硫酸沙丁胺醇雾化吸入溶液治疗小儿喘息性疾病的整体疗效确切，能迅速消除或缓解患儿喘息等症状，减轻气道局部及全身炎症反应，增强内源性抗炎保护作用，且病儿耐受性较好，值得临床推广应用。

Objective To investigate the clinical effect of Erythromycin Lactobionate for injection combined with Salbutamol Sulfate Nebules Inhalation Solution in treatment of asthmatic diseases in children. Methods A total of 102 children with asthmatic diseases admitted to The Second Hospital of Chaoyang, Liaoning from March 2017 to July 2019 were randomly divided into observation group (n=51) and control group (n=51) by random number table. The control group was treated with aerosol inhalation of Salbutamol Sulfate Nebules Inhalation Solution, age < 5 years, 2.5 mg/time, three times daily, and the age ≥ 5 years old, 5 mg/time, three times daily. The observation group were iv administered with Erythromycin Lactobionate for Injection, 30 mg/(kg·d) added into normal saline and dilute thoroughly, once daily. All patients were treated for 7 d. The clinical efficacy and main clinical symptom improvement time in two groups were compared. And the levels of IL-4, CCSP, CRP, and FeNO in two groups before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 94.1%, which was significantly higher than 80.4% of the control group (P<0.05). After treatment, the improvement time of the main clinical symptom (wheezing, cough, shortness of breath, and wheezing rale) in the observation group was significantly shorter than that in the control group (P<0.05). Compared with before treatment, FeNO concentration, serum IL-4 and CRP levels in two groups were significantly decreased after treatment (P<0.05), while serum CCSP levels were significantly increased (P<0.05). After treatment, FeNO concentration, serum IL-4 and CRP levels in the observation group were significantly lower than those in the control group (P<0.05), while the serum CCSP level were significantly higher than those in the control group (P<0.05). Conclusion Application of Erythromycin Lactobionate for injection combined with Salbutamol Sulfate Nebules Inhalation Solution in treatment of asthmatic diseases in children has a definite effect, can quickly eliminate or relieve the symptom such as breathing, reduce the local and systemic inflammatory responses in the respiratory tract, and enhance endogenous anti-inflammatory protective effect, and the patient's tolerance is great, it is worthy of clinical application.

R974

辽宁省卫生和计划生育委员会科研课题（201605A2032）