丙酸氟替卡松联合阿奇霉素对肺炎支原体感染所致慢性咳嗽儿童的肺功能、呼出气-氧化氮和炎性因子的影响

目的探讨丙酸氟替卡松联合阿奇霉素对肺炎支原体感染所致慢性咳嗽患者的肺功能、呼出一氧化氮(FeNO)和炎症因子的影响。方法选取在2018年3月-2019年3月就诊于北京市通州区妇幼保健院普儿科门诊的肺炎支原体感染所致慢性咳嗽的患儿96例作为对象,随机将患儿分为对照组(n=48例)和观察组(n=48例)。对照组口服阿奇霉素干混悬剂,10 mg/(kg·d),连续服用3 d,停药4 d,视为1个疗程,连续治疗2个疗程。观察组在对照组基础上联合丙酸氟替卡松吸入气雾剂治疗,丙酸氟替卡松吸入气雾剂连接储雾罐雾化,100μg/次,早晚各1次,连续治疗14 d。比较两组患者治疗前后的肺功能、FeNO、炎症因子及药物安全性。结果治疗后,两组肺功能1s用力呼气容积(FEV1)、肺活量(FVC)水平高于治疗前(P<0.05);观察组FEV1/FVC水平低于治疗前(P<0.05);治疗后,观察组FEV1、FVC及FEV1/FVC水平高于对照组(P<0.05)。两组治疗后FeNO、IL-6、TNF-α水平低于治疗前(P<0.05);观察组治疗后FeNO、IL-6、TNF-α水平显著低于对照组(P<0.05)。两组用药治疗过程中不良反应发生率无统计学意义。结论丙酸氟替卡松联合阿奇霉素用于肺炎支原体感染所致小儿慢性咳嗽能提高患儿肺功能水平,能降低FeNO及炎症因子水平,药物安全性较高,值得推广应用。

Effects of fluticasone propionate combined with azithromycin on lung function,exhaled nitric oxide,and inflammatory factors in children with chronic cough caused by mycoplasma pneumoniae infection

Objective To investigate the effect of fluticasone propionate combined with azithromycin on patients with chronic cough caused by mycoplasma pneumonia, and its effect on lung function, FeNO, and inflammatory factors. Methods A total of 96 children with chronic cough caused by mycoplasma pneumoniae infection in Tongzhou Maternal & Child Health Hospital of Beijing from March 2018 to March 2019 were selected as subjects, and they were randomly divided into control group(48 cases) and observation group(48 cases). Children in the control group were po administered with Azithromycin for Suspension, 10 mg/(kg·d) for 3 consecutive days, and the drug was discontinued for 4 days, which was considered as 1 course of treatment, and children were treated for 2 courses. Children in the observation group was treated with Fluticasone Propionate Inhaled Aerosol on the basis of the control group. Fluticasone Propionate Inhaled Aerosol was connected to the storage tank and atomized 100 μg/time, one time in the morning and one time in the evening for 14 d. After treatment, the levels of lung function, FeNO, inflammatory factors, and drug safety in two groups before and after treatment were compared. Results After treatment, the levels of FEV1, FVC in two groups were significantly increased(P < 0.05), FEV1/FVC in the observation group were decreased(P < 0.05), and the levels of FEV1,FVC, and FEV1/FVC in the observation group were higher than those in the control group(P < 0.05). After treatment, FeNO, IL-6,and TNF-α levels in two groups were significantly decreased, and the levels of FeNO, IL-6, and TNF-α were significantly lower than those in the control group(P < 0.05). The incidence of adverse reactions during the treatment of the two groups was not statistically significant.Conclusion Fluticasone propionate combined with azithromycin for chronic cough caused by mycoplasma pneumoniae infection in children can improve the level of lung function, reduce the level of FeNO and inflammatory factors, the drug is safe and worthy of promotion.