2021 年第 10 期 第 16 卷

西替利嗪联合布地奈德对支气管哮喘患儿临床疗效以及血清骨膜蛋白和溶血卵磷脂水平的影响

Clinical effect of cetirizine combined with budesonide on children with bronchial asthma and the influence on serum periosteal protein and lysolecithin levels

作者：丁妞陈艳萍吴碧琛罗淑娟

英文作者：Ding Niu Chen Yanping Wu Bichen Luo Shujuan

单位：湖南省儿童医院呼吸内科，长沙410007

英文单位：Department of Respiratory Hunan Children′s Hospital Changsha 410007 China

关键词：支气管哮喘；西替利嗪；布地奈德；骨膜蛋白；溶血卵磷脂

英文关键词：Bronchialasthma;Cetirizine;Budesonide;Periostealprotein;Lysolecithin

• 摘要：

• 目的  探讨西替利嗪联合布地奈德对支气管哮喘患儿临床疗效以及血清骨膜蛋白和溶血卵磷脂水平的影响。方法 选取湖南省儿童医院2018年12月至2020年10月收治的支气管哮喘急性发作患儿98例。应用随机数字表法分为对照组和观察组，各49例。对照组给予布地奈德气雾剂雾化吸入治疗，观察组在对照组的治疗基础上口服西替利嗪片，2组均治疗7 d。比较2组患儿的临床疗效以及治疗前后肺功能、免疫细胞、免疫因子以及血清骨膜蛋白和溶血卵磷脂水平。结果 治疗7 d后，观察组总有效率高于对照组［95.9%(47/49)比83.7%（41/49）］，差异有统计学意义（χ2=4.009，P<0.05）。治疗前2组患儿肺功能指标、免疫细胞、免疫因子水平比较差异均无统计学意义（均P>0.05）；治疗后，2组患儿呼气峰值流速、第1秒用力呼气容积（FEV1）和FEV1占预计值的百分比以及CD+8水平均高于本组治疗前，且观察组均高于对照组（均P<0.05），血清CD+3、CD+4、CD+4/CD+8和免疫球蛋白E细胞水平均低于本组治疗前、且观察组均低于对照组（均P<0.05）。治疗前2组患儿血清骨膜蛋白和溶血卵磷脂水平比较差异均无统计学意义（均P>0.05）；治疗后，2组患儿血清骨膜蛋白和溶血卵磷脂水平均低于本组治疗前，且观察组均低于对照组［(70±12)μg/L比（78±14）μg/L，（38±4）ng/L比（46±5）ng/L］（均P<0.05）。结论 西替利嗪联合布地奈德治疗支气管哮喘患儿效果显著，可以显著改善患儿肺功能，提高机体免疫功能，降低血清骨膜蛋白和溶血卵磷脂水平。

• Objective To investigate the clinical effect of cetirizine combined with budesonide on children with bronchial asthma and the influence on serum periosteal protein and lysolecithin levels. Methods From December 2018 to October 2020, 98 children with acute attack of bronchial asthma in Hunan Children′s Hospital were selected. They were randomly divided into control group and observation group with 49 cases in each group. The control group was given budesonide aerosol atomization inhalation treatment, and the observation group was given cetirizine tablets orally on the basis of the control group. Both groups were treated for 7 d. The clinical effect, lung function, immune cells, immune factors, serum periosteal protein and lysolecithin levels before and after treatment were compared between the two groups. Results After 7 d of treatment, the total effective rate of the observation group was higher than that of the control group ［95.9%(47/49) vs 83.7%(41/49)］, and the difference was statistically significant（χ2=4.009，P<0.05）. Before treatment, there were no significant differences in lung function indexes, immune cells and immune factors levels between the two groups (all P>0.05). After treatment, the peak expiratory flow rate, forced expiratory volume in the first second (FEV1), FEV1 as apercentage of estimated value (FEV1%) and CD+8 level of the two groups were higher than those before treatment, and those of the observation group were higher than those of the control group (all P<0.05); the serum CD+3, CD+4, CD+4/CD+8 and immunoglobulin E cell levels of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group (all P<0.05). There were no significant differences in serum periosteal protein and lysolecithin levels between the two groups before treatment (both P>0.05); after treatment, the serum periosteal protein and lysolecithin levels of the two groups were lower than those before treatment, and those of the observation group was lower than those of the control group ［(70±12)μg/L vs (78±14）μg/L，（38±4)ng/L vs (46±5) ng/L］(all P<0.05). Conclusion Cetirizine combined with budesonide has a significant effect on the treatment of children with bronchial asthma, and can significantly improve the lung function, improve the immune function, and reduce serum periosteal protein and lysolecithin levels. s  Procalcitonin level in patients with heart failure caused by noninfectious factors decreased gradually with treatment. Procalcitonin can be used as a clinical basis for monitoring and evaluating prognosis of heart failure caused by noninfectious factors.