河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (1): 86-90.doi: 10.3969/j.issn.1007-3205.2023.01.017

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硫酸镁雾化吸入辅助治疗对重症毛细支气管炎患儿气道阻力、肺功能及炎症因子的影响

  

  1. 河北省沧州市人民医院儿科， 河北 沧州 061000

  • 出版日期:2023-01-25 发布日期:2023-01-17
  • 作者简介:司永华（1985-），女，河北沧州人，河北省沧州市人民医院主治医师，医学硕士，从事小儿呼吸系统疾病诊治研究。
  • 基金资助:
    沧州市科学技术研究与发展指导计划项目（172302140）

Effects of magnesium sulfate atomization inhalation as adjuvant therapy on airway resistance, pulmonary function and inflammatory factors in children with severe bronchiolitis

  1. Department of Pediatrics, Cangzhou People′s Hospital, Hebei Province, Cangzhou 061000, China

  • Online:2023-01-25 Published:2023-01-17

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摘要： 目的  观察硫酸镁雾化吸入辅助治疗对重症毛细支气管炎患儿气道阻力、肺功能及炎症因子的影响。
方法  选择于医院治疗的重症毛细支气管炎患儿88例，以随机数字表法分组，44例患儿为探究组，采用硫酸镁雾化吸入辅助常规治疗，44例患儿为参照组，采用常规治疗，两组患儿均连续治疗7 d，治疗前、后检测两组患儿炎症指标：肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）、可溶性血管细胞黏附分子1（soluble vasccular cell adhesion molecule-1,sVCAM-1）、Nod 样受体蛋白3（Nod-like receptor pyrin domain3,NLRP3）、嗜酸粒细胞阳离子蛋白（eosinophil cationic protein,ECP）水平：气道阻力指标：近端气道黏性阻力(R20)、气道总阻抗(Z5)、气道总黏性阻力(R5)、肺神经源性P物质水平；肺功能指标：有效呼吸道阻力（Reff）、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、最大呼气中段流量(maximal mid-expiratory flow curve,MMF)、呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)水平，记录两组患儿发热消失时间、湿啰音消失时间、憋喘消失时间、咳嗽消失时间。
结果  探究组患儿TNF-α、sVCAM-1、ECP、NLRP3水平低于参照组（P＜0.05），探究组患儿Z5、R20、R5、肺神经源性P物质水平低于参照组（P＜0.05），探究组MMF、FeNO水平高于参照组（P＜0.05），探究组Reff、FeNO水平低于参照组（P＜0.05），探究组患儿发热消失时间、湿啰音消失时间、憋喘消失时间、咳嗽消失时间短于参照组（P＜0.005）。
结论  硫酸镁雾化吸入辅助治疗重症毛细支气管炎患儿，可抑制患儿炎症反应，改善患儿气道阻力，提升患儿肺功能，缓解患儿临床症状。


关键词: 毛细支气管炎, 硫酸镁, 气道阻力

Abstract: Objective  To observe the effect of magnesium sulfate atomization inhalation as adjuvant therapy on airway resistance, pulmonary function and inflammatory factors in children with severe bronchiolitis. 
Methods  A total of 88 patients with severe bronchiolitis who were treated in the hospital were selected. They were divided into two groups by random number table method: the research group (treated with magnesium sulfate atomization inhalation as an auxiliary therapy to conventional treatment, n=44) and control group (treated with conventional treatment, n=44). Both groups were treated for 7 consecutive days. Before and after treatment, the inflammatory indicators ［tumor necrosis factor-α (TNF-α), soluble vascular cell adhesion molecule-1 (sVCAM-1), Nod-like receptor pyrin domain-3 (NLRP3), eosinophil cationic protein (ECP) levels］, airway resistance indicators ［proximal airway viscous resistance (R20), total airway resistance (Z5), total airway viscous resistance (R5), pulmonary neurogenic substance P level］, and pulmonary function indicators ［effective airway resistance (Reff), forced expiratory volume in 1 second (FEV1), maximum mid-expiratory flow (MMF) and fractional exhaled nitric oxide (FeNO) levels］ in the two groups were detected. The disappearance time of fever, wet rales, wheezing, and cough was recorded in the two groups of children. 
Results  The levels of TNF-α, sVCAM-1, ECP and NLRP3 in the research group were lower than those in the control group (P＜0.05), and the levels of Z5, R20, R5 and pulmonary neurogenic substance P in the research group were lower than those in the control group (P＜0.05). The levels of MMF and FeNO in the research group were higher than those in the control group (P＜0.05), while the levels of Reff and FeNO in the research group were lower than those in the control group (P＜0.05). The disappearance time of fever, wet rales, wheezing, and cough in the research group was shorter than that in the control group (P＜0.005). 
Conclusion  Magnesium sulfate atomization inhalation as adjuvant therapy for children with severe bronchiolitis can inhibit the inflammatory response, improve the airway resistance and the pulmonary function, and relieve the clinical symptoms of the children. 


Key words: bronchiolitis, magnesium sulfate, airway resistance

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