目的 探討小兒喘息性疾病應用注射用乳糖酸紅霉素聯(lián)合硫酸沙丁胺醇霧化吸入溶液治療的臨床效果。方法 選取2017年3月—2019年7月遼寧省朝陽市第二醫(yī)院收治的102例喘息性疾病患兒，運用隨機數(shù)字表法將其隨機分成觀察組（n=51）和對照組（n=51）。其中對照組采取硫酸沙丁胺醇霧化吸入溶液氧氣驅動霧化吸入治療，年齡<5歲者，2.5 mg/次，3次/d；≥5歲者，5 mg/次，3次/d。觀察組在對照組基礎上靜脈滴注注射用乳糖酸紅霉素治療，30 mg/（kg·d）加入生理鹽水中充分稀釋，1次/d。所有患兒均治療7 d。比較兩組臨床療效及主要臨床癥狀改善時間，治療前后的白細胞介素-4（IL-4）、Clara細胞分泌蛋白（CCSP）、C反應蛋白（CRP）、呼出氣一氧化氮（FeNO）水平變化。結果 治療后，觀察組總有效率為94.1%，較對照組的80.4%顯著提高（P<0.05）。治療后，觀察組臨床癥狀（喘息、咳嗽、氣促、哮鳴音等）的改善時間均顯著短于對照組（P<0.05）。與治療前相比，兩組治療后FeNO濃度及血清IL-4、CRP水平均顯著降低（P<0.05），血清CCSP水平則均顯著增高（P<0.05）；且治療后，觀察組FeNO濃度和血清IL-4、CRP水平均顯著低于對照組（P<0.05），而血清CCSP水平顯著高于對照組（P<0.05）。結論 應用注射用乳糖酸紅霉素聯(lián)合硫酸沙丁胺醇霧化吸入溶液治療小兒喘息性疾病的整體療效確切，能迅速消除或緩解患兒喘息等癥狀，減輕氣道局部及全身炎癥反應，增強內源性抗炎保護作用，且病兒耐受性較好，值得臨床推廣應用。

Objective To investigate the clinical effect of Erythromycin Lactobionate for injection combined with Salbutamol Sulfate Nebules Inhalation Solution in treatment of asthmatic diseases in children. Methods A total of 102 children with asthmatic diseases admitted to The Second Hospital of Chaoyang, Liaoning from March 2017 to July 2019 were randomly divided into observation group (n=51) and control group (n=51) by random number table. The control group was treated with aerosol inhalation of Salbutamol Sulfate Nebules Inhalation Solution, age < 5 years, 2.5 mg/time, three times daily, and the age ≥ 5 years old, 5 mg/time, three times daily. The observation group were iv administered with Erythromycin Lactobionate for Injection, 30 mg/(kg·d) added into normal saline and dilute thoroughly, once daily. All patients were treated for 7 d. The clinical efficacy and main clinical symptom improvement time in two groups were compared. And the levels of IL-4, CCSP, CRP, and FeNO in two groups before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 94.1%, which was significantly higher than 80.4% of the control group (P<0.05). After treatment, the improvement time of the main clinical symptom (wheezing, cough, shortness of breath, and wheezing rale) in the observation group was significantly shorter than that in the control group (P<0.05). Compared with before treatment, FeNO concentration, serum IL-4 and CRP levels in two groups were significantly decreased after treatment (P<0.05), while serum CCSP levels were significantly increased (P<0.05). After treatment, FeNO concentration, serum IL-4 and CRP levels in the observation group were significantly lower than those in the control group (P<0.05), while the serum CCSP level were significantly higher than those in the control group (P<0.05). Conclusion Application of Erythromycin Lactobionate for injection combined with Salbutamol Sulfate Nebules Inhalation Solution in treatment of asthmatic diseases in children has a definite effect, can quickly eliminate or relieve the symptom such as breathing, reduce the local and systemic inflammatory responses in the respiratory tract, and enhance endogenous anti-inflammatory protective effect, and the patient's tolerance is great, it is worthy of clinical application.

R974

遼寧省衛(wèi)生和計劃生育委員會科研課題（201605A2032）