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[摘要]
目的 评价单磷酸阿糖腺苷联合复方异丙托溴铵、布地奈德治疗小儿毛细支气管炎疗效及对血清样淀粉蛋白A (SAA)水平的影响。方法 选取2016年2月-2017年12月收治的毛细支气管炎患儿110例,随机分为观察组和对照组,每组55例。对照组给予布地奈德混悬液0.5 mg联合复方异丙托溴铵1.25 mL溶入3 mL生理盐水中雾化吸入。观察组在对照组的基础上加用单磷酸阿糖腺苷10 mg溶于5%葡萄糖溶液100 mL中iv。两组均治疗7 d,比较两组临床疗效(包括发热、咳喘、啰音等)以及治疗前后血清SAA、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以及IL-8水平。结果 观察组和对照组的总有效率分别为96.4%和83.6%,差异有统计学意义(P<0.05);治疗后观察组症状体征消失时间和住院时间与对照组相比明显缩短,差异有统计学意义(P<0.05);治疗后两组患儿血清SAA表达水平及血清TNF-α、IL-6及IL-8水平均较治疗前明显下降,且观察组显著低于对照组,差异有统计学意义(P<0.05)。结论 单磷酸阿糖腺苷联合复方异丙托溴铵、布地奈德治疗小儿毛细支气管炎疗效确切,可改善机体免疫功能及降低炎症指标,值得临床推广应用。
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[Abstract]
Objective To study the effect of adenosine monophosphate combined with ipratropium bromide and budesonide on pediatric bronchiolitis and its effect on serum and serum amyloid A (SAA) levels.Methods A total of 110 children with bronchiolitis who were admitted to our hospital from February 2016 to December 2017 were randomly divided into observation group and control group,55 cases in each group.Both groups received conventional treatment,and the control group was given budesonide suspension 0.5 mg combined with compound ipratropium bromide 1.25 mL dissolved in 3 mL saline aerosol inhalation.The observation group was given intravenous injection of adenosine monophosphate 10 mg dissolved in 100 mL 5% glucose solution on the basis of the observation group.All patients were treated for 7 days.The patient's condition was observed and recorded,including the time of fever,the disappearance time of wet rales,the time of wheezing disappeared,the time of disappearance of cough,and the time of hospitalization.The curative effect and levels of SAA,TNF-α,IL-6 and IL-8 were compared between the two groups.Results The total effective rates of the observation group and the control group were respectively 96.4% and 83.6%.There was a statistically significant difference between the two groups (P<0.05).The treatment time and hospitalization time for the improvement of clinical symptoms were significantly lower than the control group,and there was a statistically significant difference between the two groups (P<0.05).The evels of SAA,TNF-α,IL-6 and IL-8 in the observation group were significantly lower than those in the control group and before treatment,and the difference between the two groups was statistically significant (P<0.05).Conclusion Adenosine monophosphate combined with ipratropium bromide and budesonide has a definite curative effect on pediatric bronchiolitis,it can improve immune function and reduce inflammation index.It is worthy of clinical application.
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