丙卡特罗联合无创正压通气在支气管哮喘患儿急性发作中的疗效研究

Efficacy of procaterol combined with non-invasive positive pressure ventilation in acute attacks of bronchial asthma among children

摘要:

目的 研究支气管哮喘患儿急性发作中使用丙卡特罗联合无创正压通气（NIPPV）的临床疗效。方法 选取2019年12月—2022年12月庆阳市人民医院收治的支气管哮喘患儿82例，随机分为NIPPV组（NIPPV治疗）和联合组（丙卡特罗联合NIPPV治疗），每组41例。比较两组恢复速度、疗效及不良反应；比较治疗前后两组血清基质金属蛋白酶-9（MMP-9）、转化生长因子-β₁（TGF-β₁）、骨桥蛋白（OPN）水平、白细胞介素-5（IL-5）、干扰素-γ（IFN-γ）水平及Th1/Th2的变化。结果 NIPPV组喘息、气促、哮鸣音、咳嗽消失时间及住院时间均长于联合组（P <0.05）。NIPPV组总有效率低于联合组（P <0.05）。NIPPV组治疗前后Th1/Th2比值及血清MMP-9、TGF-β₁、OPN、IL-5、IFN-γ的差值均小于联合组（P <0.05）。两组均未出现明显不良反应，联合组1例轻微面部潮红，未经干预即好转。结论 丙卡特罗联合NIPPV可加快支气管哮喘急性发作患儿恢复速度，提高疗效，改善气道重塑及Th1/Th2失衡，且安全可靠。

Abstract:

Objective To investigate the clinical efficacy of procaterol combined with non-invasive positive pressure ventilation (NIPPV) in acute attacks of bronchial asthma among children.Methods A total of 82 children with bronchial asthma admitted to our hospital from December 2019 to December 2022 were selected and randomly divided into NIPPV treatment group (NIPPV treatment) and combined group (procaterol combined with NIPPV treatment), with 41 cases in each group. The time to recovery, therapeutic efficacy and incidence of adverse reactions in the two groups were compared. The changes in the serum levels of matrix metalloproteinase-9 (MMP-9), transforming growth factor-β₁ (TGF-β₁), osteopontin (OPN), interleukin5 (IL-5), and interferon-γ (IFN-γ) as well as the Th1/Th2 ratio before and after the treatment were compared between the two groups.Results The time to disappearance of wheezing, shortness of breath, wheezing sound, and cough as well as the length of hospital stay in the NIPPV treatment group were longer than those in the combined group (P < 0.05). The overall effective rate of the NIPPV treatment group was lower than that of the combined group (P < 0.05). The differences of the Th1/Th2 ratio and serum levels of MMP-9, TGF-β₁, OPN, IL-5 and IFN-γ before and after the treatment in the NIPPV treatment group were lower than those in the combined group (P < 0.05). There were no obvious adverse reactions in both groups, while 1 case in the combined group had mild facial flushing, which was improved without intervention.Conclusions Procaterol combined with NIPPV may promote the recovery, enhance the therapeutic efficacy, and improve airway remodeling and Th1/Th2 imbalance in children with acute attacks of bronchial asthma, with good reliability yet fewer safety concerns.