氨溴索联合布地奈德雾化治疗新生儿肺炎的临床疗效

目的探讨氨溴索联合布地奈德雾化治疗新生儿肺炎对辅助型T细胞17/调节型T细胞(Th17/Treg)、氧化应激的影响。方法选择乐山市人民医院儿科新生儿病房2019年3月—2020年9月收治的新生儿肺炎120例,随机分为研究组(n=60)和对照组(n=60)。对照组采用布地奈德雾化治疗,研究组采用布地奈德+氨溴索进行雾化治疗;采用酶联免疫吸附法检测两组治疗前后血清中白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、干扰素-γ(IFN-γ)、转化生长因子-β(TGF-β);晚期蛋白氧化产物(AOPP)及抗氧化指标超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平。结果120株检出病原中细菌共62株,占51.67%,真菌7株,占5.83%,病毒51株,占42.50%,金黄色葡萄球菌、铜绿假单胞菌、呼吸道合胞病毒、腺病毒检出率较高;研究组疗效优于对照组(Z=1.734,P=0.005);研究组发热消退时间、咳嗽、气喘消失时间短于对照组(P<0.05);治疗后两组IL-17、IL-23、AOPP水平下降,IFN-γ、TGF-β、SOD、GSH-Px水平上升,较治疗前差异具有统计学意义(P<0.05);治疗7 d后研究组IL-17、IL-23、AOPP水平低于对照组,IFN-γ、TGF-β、SOD、GSH-Px水平高于对照组(P<0.05)。结论氨溴索联合布地奈德雾化治疗可有效治疗新生儿肺炎感染,其机制可能与调节Th17/Treg免疫平衡,降低机体氧化应激水平有关。

Clinical effect of ambroxol combined with budesonide atomization on treatment of neonates with pneumonia

OBJECTIVE To explore the effect of ambroxol combined with budesonide atomization on helper T cells 17/regulatory T cells(Th17/Treg)and oxidative stress of the neonates with pneumonia.METHODS A total of 120 neonates with pneumonia who were treated in neonatal wards of pediatrics department of Leshan People’s Hospital from Mar 2019 to Sep 2020 were enrolled in the study and randomly divided into the study group with 60 cases and the control group with 60 cases.The control group was treated with budesonide nebulization,and the study group was treated with budesonide plus ambroxol nebulization.The levels of serum interleukin-17(IL-17),interleukin-23(IL-23),interferon-γ(IFN-γ)and transforming growth factor-β(TGF-β)were detected by using enzyme-linked immunosorbent assay before and after the treatment,and the levels of advanced protein oxidation products(AOPP)and antioxidant indexes superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)were also detected.RESULTS Totally 120 strains of pathogens were isolated,62(51.67%)of which were bacteria,7(5.83%)were fungi,and 51(42.50%)were viruses.The isolation rates of Staphylococcus aureus,Pseudomonas aeruginosa,respiratory syncytial virus,and adenovirus were relatively high.The curative effect of the study group was significantly better than that of the control group(Z=1.734,P=0.005).The time of disappearance of fever,cough and asthma of the study group were significantly shorter than that of the control group(P<0.05).The levels of IL-17,IL-23 and AOPP of the two groups were significantly reduced after the treatment,while the levels of IFN-γ,TGF-β,SOD and GSH-Px were elevated(P<0.05).The levels of IL-17,IL-23 and AOPP of the study group were significantly lower than those of the control group after the treatment for 7 days,and the levels of IFN-γ,TGF-β,SOD and GSH-Px of the study group were significantly higher than those of the control group(P<0.05).CONCLUSION Ambroxol combined with budesonide atomization is effective in treatment of the neonates with pneumonia,and its mechanisms may be related to the regulation of Th17/Treg immune balance and reduction of body’s oxidative stress level.