异丙托溴铵联合抗菌药物对支气管哮喘合并肺部感染患儿的影响

Effects of ipratropium bromide combined with antibacterial drugs on children with bronchial asthma complicated by pulmonary infection

摘要:

目的 探讨异丙托溴铵联合抗菌药物对支气管哮喘合并肺部感染患儿的影响。方法 选取2022年3月—2025年3月连云港市第一人民医院收治的120例支气管哮喘合并肺部感染患儿作为研究对象，采用信封抽签法随机分为抗菌组（60例，接受抗菌药物治疗）和联合组（60例，接受异丙托溴铵联合抗菌药物治疗）。对比两组患儿的临床疗效、症状缓解时间、治疗前后肺功能指标［第1秒用力呼气量（FEV₁）、用力肺活量（FVC）、呼气流量峰值（PEF）］、免疫指标［免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白E（IgE）］及炎症因子［C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）］。结果 联合组总有效率高于抗菌组（P 0.05）。联合组呼吸困难消失时间、咳嗽咳痰缓解时间、肺部啰音消失时间和喘息消失时间均短于抗菌组（P 0.05）。联合组治疗后FEV₁、FVC、PEF均高于抗菌组（P 0.05）。联合组治疗前后FEV₁、FVC、PEF的差值均大于抗菌组（P 0.05）。联合组治疗后IgA、IgM均高于抗菌组（P 0.05），IgE低于抗菌组（P 0.05）。联合组治疗前后IgA、IgM、IgE的差值均大于抗菌组（P 0.05）。联合组治疗后CRP、IL-6、TNF-α均低于抗菌组（P 0.05）。联合组治疗前后CRP、IL-6、TNF-α的差值均大于抗菌组（P 0.05）。结论 异丙托溴铵联合抗菌药物对支气管哮喘合并肺部感染患儿具有显著的积极治疗影响，可提升疗效、缩短症状缓解时间、改善肺功能，同时调节免疫功能并减轻机体炎症反应。

Abstract:

Objective To investigate the effects of ipratropium bromide combined with antibacterial drugs on children with bronchial asthma complicated by pulmonary infection.Methods A total of 120 children with bronchial asthma complicated by pulmonary infection admitted to the hospital from March 2022 to March 2025 were enrolled in this study. Using the envelope randomization method, the patients were randomly divided into an antibacterial group (n = 60), who received antibacterial drug therapy, and a combination group (n = 60), who received ipratropium bromide combined with antibacterial drugs. The clinical efficacy, symptom relief time, and pulmonary function indicators [forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow (PEF) ], immune indicators [immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin E (IgE) ] and inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) ] before and after treatment were compared between the two groups.Results The overall effective rate of treatment in the combination group was significantly higher than that in the antibacterial group (P 0.05). The combination group had shorter times to resolution of dyspnea, relief of cough and sputum, disappearance of pulmonary rales, and cessation of wheezing compared with the antibacterial group (P 0.05). After treatment, the FEV₁, FVC and PEF in the combination group were significantly higher than those in the antibacterial group (P 0.05). The differences of these indicators before and after treatment were also greater in the combination group (P 0.05). After treatment, the combination group had higher levels of IgA and IgM and lower levels of IgE than the antibacterial group (P 0.05). The changes in IgA, IgM, and IgE before and after treatment were all greater in the combination group than in the antibacterial group (P 0.05). After treatment, the levels of CRP, IL-6, and TNF-α in the combination group were lower than those in the antibacterial group (P 0.05), and the changes in CRP, IL-6, and TNF-α before and after treatment were all greater in the combination group than in the antibacterial group (P 0.05).Conclusion Ipratropium bromide combined with antibacterial drugs exerts a significant positive therapeutic effect on children with bronchial asthma complicated by pulmonary infection. It improves the clinical efficacy, shortens the symptom relief time, ameliorates pulmonary function, regulates immune function and alleviates the systemic inflammatory response simultaneously.