作　　者： (李敏）; (魏朝霞）;

机构地区： 广饶县中医院儿科,山东广饶257000

出　　处： 《医学综述》 2017年第17期3529-3532,共4页

摘　　要： 目的比较沙美特罗替卡松和糖皮质激素气雾剂治疗小儿哮喘的效果。方法选择2012年9月至2013年10月广饶县中医院收治的82例支气管哮喘患儿为研究对象,按照随机数字法将其分为沙美特罗替卡松组(40例)和糖皮质激素组(42例)。糖皮质激素组给予丙酸氟替卡松气雾剂治疗,每次1喷,每日2次;沙美特罗替卡松组患儿给予沙美特罗替卡松治疗,每次1喷,每日2次。于治疗前、治疗后1个月、2个月检测患儿血清基质金属蛋白酶(MMP)-2、MMP-3、MMP-9及组织金属蛋白酶抑制剂(TIMP)1水平,记录患者的肺换气功能(肺血分流率、肺泡气-动脉氧分压差以及最大口腔吸气压)的改善情况及疗效。结果两组患儿血清MMP-2、MMP-3、MMP-9和TIMP-1水平在组间、时点间及组间·时点间比较,差异均有统计学意义(P<0.05),治疗后两组患儿MMP-2、3、9及TIMP-1水平均显著降低,且沙美特罗替卡松组MMP-2、3、9及TIMP-1水平较糖皮质激素组更低;治疗后,两组患儿的换气功能均得到显著改善,肺血分流率、肺泡气-动脉氧分压差及最大口腔吸气压组间、时点间、组间·时点间比较差异均有统计学意义(P<0.05);沙美特罗替卡松组肺血分流率和肺泡气-动脉氧分压差显著低于糖皮质激素组(P<0.05),最大口腔吸气压水平均显著高于糖皮质激素组(P<0.05)。沙美特罗替卡松组患儿的疗效有效率均显著高于糖皮质激素组[95.0%(38/40)比80.9%(34/42)](P<0.05)。结论沙美特罗替卡松较单用糖皮质激素治疗小儿支气管哮喘的疗效显著,其能明显降低血清MMP-2、3、9以及TIMP-1的水平,并改善患儿换气功能。 Objective To study the effect of glucocortieoids aerosols and salmeterol/fluticasone on treatment of asthma in children. Method A.total of 82 cases of bronchial asthma children in Guangrao County Traditional Chinese Medicine Hospital from Sep. 2012 to Oct. 2013 were collected,and then randomly divided into a salmeterol/fluticasone group（40 cases） and a glucocorticoid group（42 cases） according to random number table method. The glucoeorticoid group was given fluticasone propionate, one spray per time, twice a day. The salmeterol/fluticasone group was given salmeterol/fluticasone for treatment,one spray per time,twice a day. The serum levels of matrix metalloproteinases（MMP） -2 ,MMP-3 ,MMP-9 and tissue inhibitor of metalloproteinase（TIMP）-1 before treatment, one month and two months after treatment were detected and the pulmonary ventilation function（ pulmonary shunt rate,alveolar-arterial oxygen partial pressure difference, and the maximum oral inspiratory pressure） and curative effect were recorded. Results After treatment, the levels of MMP-2, MMP-3, MMP-9 and TIMP-1 of the two groups between groups ,time points and group · time points had statistically significant differences（P 〈0.05） ,after treatment the levels of MMP-2,MMP-3 ,MMP-9 and TIMP-1 were obviously lower than before treatment, and the salmeterol/fluticasone group was lower than the glucocorticoid group. After treatment, the pulmonary ventilation function was improved, the pulmonary shunt rate, alveolar-arterial oxygen partial pressure difference and maximum oral inspiratory pressure between different groups, time points and group · time interaction were statistically different （P 〈 0.05 ）, the pulmonary shunt rate and alveolar-arterial oxygen partial pressure difference of the salmeterol/fluticasone group was lower than that of the glucocorticoids group, and maximum oral inspiratory pressure was higher than that of the glucocorticoids group（ P 〈 0.05 ）. The curative effect of the salmeterol/fluticasone group wa

关 键 词： 哮喘 儿童 基质金属蛋白酶 肺功能 糖皮质激素 沙美特罗替卡松