目的 評價單磷酸阿糖腺苷聯(lián)合復(fù)方異丙托溴銨、布地奈德治療小兒毛細(xì)支氣管炎療效及對血清樣淀粉蛋白A （SAA）水平的影響。方法 選取2016年2月-2017年12月收治的毛細(xì)支氣管炎患兒110例，隨機(jī)分為觀察組和對照組，每組55例。對照組給予布地奈德混懸液0.5 mg聯(lián)合復(fù)方異丙托溴銨1.25 mL溶入3 mL生理鹽水中霧化吸入。觀察組在對照組的基礎(chǔ)上加用單磷酸阿糖腺苷10 mg溶于5%葡萄糖溶液100 mL中iv。兩組均治療7 d，比較兩組臨床療效（包括發(fā)熱、咳喘、啰音等）以及治療前后血清SAA、腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）以及IL-8水平。結(jié)果 觀察組和對照組的總有效率分別為96.4%和83.6%，差異有統(tǒng)計學(xué)意義（P<0.05）；治療后觀察組癥狀體征消失時間和住院時間與對照組相比明顯縮短，差異有統(tǒng)計學(xué)意義（P<0.05）；治療后兩組患兒血清SAA表達(dá)水平及血清TNF-α、IL-6及IL-8水平均較治療前明顯下降，且觀察組顯著低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 單磷酸阿糖腺苷聯(lián)合復(fù)方異丙托溴銨、布地奈德治療小兒毛細(xì)支氣管炎療效確切，可改善機(jī)體免疫功能及降低炎癥指標(biāo)，值得臨床推廣應(yīng)用。

Objective To study the effect of adenosine monophosphate combined with ipratropium bromide and budesonide on pediatric bronchiolitis and its effect on serum and serum amyloid A (SAA) levels.Methods A total of 110 children with bronchiolitis who were admitted to our hospital from February 2016 to December 2017 were randomly divided into observation group and control group,55 cases in each group.Both groups received conventional treatment,and the control group was given budesonide suspension 0.5 mg combined with compound ipratropium bromide 1.25 mL dissolved in 3 mL saline aerosol inhalation.The observation group was given intravenous injection of adenosine monophosphate 10 mg dissolved in 100 mL 5% glucose solution on the basis of the observation group.All patients were treated for 7 days.The patient's condition was observed and recorded,including the time of fever,the disappearance time of wet rales,the time of wheezing disappeared,the time of disappearance of cough,and the time of hospitalization.The curative effect and levels of SAA,TNF-α,IL-6 and IL-8 were compared between the two groups.Results The total effective rates of the observation group and the control group were respectively 96.4% and 83.6%.There was a statistically significant difference between the two groups (P<0.05).The treatment time and hospitalization time for the improvement of clinical symptoms were significantly lower than the control group,and there was a statistically significant difference between the two groups (P<0.05).The evels of SAA,TNF-α,IL-6 and IL-8 in the observation group were significantly lower than those in the control group and before treatment,and the difference between the two groups was statistically significant (P<0.05).Conclusion Adenosine monophosphate combined with ipratropium bromide and budesonide has a definite curative effect on pediatric bronchiolitis,it can improve immune function and reduce inflammation index.It is worthy of clinical application.