童建明

【摘要】 目的：探討特布他林辅助治疗支原体肺炎患儿的临床效果及对炎症因子及呼吸功能的改善情况。方法：选择2017年8月-2018年8月于本院就诊的肺炎患儿104例，按照随机数字表法将其分为联合治疗组（n=52）及阿奇霉素组（n=52），两组均予以阿奇霉素贯序治疗，而联合治疗组在此基础上加用特布他林雾化吸入。治疗1个疗程后，比较两组治疗效果、一般情况、治疗前后炎症相关指标及呼吸功能指标、不良反应发生情况。结果：联合治疗组治疗总有效率明显高于阿奇霉素组（P<0.05）;联合治疗组各症状消失时间以及住院时间均明显短于阿奇霉素组（P<0.05）;联合治疗组治疗后C反应蛋白（CRP）、嗜酸性粒细胞计数（EOS）、肿瘤坏死因子（TNF-α）及白介素-2（IL-2）均明显低于阿奇霉素组（P<0.05）;联合治疗组治疗后第一秒用力呼吸量（FEV1）、最大呼吸峰流速（PEF）及FEV1/FVC均明显高于阿奇霉素组（P<0.05）;两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：特布他林辅助阿奇霉素贯序治疗小儿肺炎疗效显著，且能进一步改善患儿相关临床症状及呼吸功能，降低血清炎性因子指标，安全性也较好。

【关键词】 小儿肺炎; 支原体; 特布他林; 阿奇霉素; 贯序疗法

【Abstract】 Objective：To investigate the clinical effects of Terbutaline in the treatment of children with mycoplasmal pneumonia，and the improvement of inflammatory factors and respiratory function.Method：A total of 104 children with pneumonia admitted to our hospital from August 2017 to August 2018 were selected.They were divided into combination treatment group（n=52）and Azithromycin group（n=52）according to the random number table method.The Azithromycin group was treated with Azithromycin sequential therapy，the combined treatment group added Terbutaline atomization inhalation on this basis.After one course of treatment，the treatment effects，general conditions，the inflammatory and respiratory function indicators before and after treatment，the adverse reactions of two groups were compared.Result：The total effective rate in the combination treatment group was significantly higher than that in the Azithromycin group（P<0.05）.The time of each symptom disappearance and the hospitalization time in the combination treatment group were significantly shorter than those in the Azithromycin group（P<0.05）.The levels of C-reactive protein（CRP），eosinophilic granulocytes（EOS），tumor necrosis factor-α（TNF-α）and interleukin-2（IL-2）in the combination treatment group were significantly lower than those in the Azithromycin group（P<0.05）.The forced expiratory volume in one second（FEV1），peak expiratory flow（PEF）and FEV1/FVC in the combination treatment group were significantly higher than those in the Azithromycin group（P<0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：Terbutaline combined with Azithromycin in the sequential therapy of pediatric pneumonia has a significant effect，and it can further improve the clinical symptoms and respiratory function of children，reduce serum inflammatory factor indicators，and its safety is also good.

【Key words】 Pediatric pneumonia; Mycoplasma; Terbutaline; Azithromycin; Sequential therapy

First-authors address：Peoples Hospital of Qingxin District in Qingyuan，Qingyuan 511800，China

doi：10.3969/j.issn.1674-4985.2019.16.001

小儿肺炎病原体相对复杂，病情进一步发展成为重症肺炎会导致患儿发生严重并发症甚至死亡，而支原体肺炎是目前临床最常见的小儿肺炎类型之一[1]。有研究表明，阿奇霉素贯序治疗小儿支原体肺炎效果相对较好，对此类疾病治疗效果显著，但治疗后患儿症状改善情况不理想，咳嗽等临床症状持续时间较长，对患儿生活及学习影响较大[2-3]。而特布他林作为支气管扩张剂，对哮喘患儿的咳嗽、喘息等临床症状改善效果较好[4]。故本研究将其加入阿奇霉素贯序治疗应用于小儿支原体肺炎，现报道如下。

1 资料与方法

1.1 一般资料 选择2017年8月-2018年8月于本院儿科就诊的支原体肺……