重組人干擾素α-1b不同給藥途徑治療嬰幼兒毛細(xì)支氣管炎的臨床研究
發(fā)布時間：2018-07-14 19:48
【摘要】：目的:評價重組人干擾素α-1b(Recombinan human Interf--eronα-1b,rh IFN-α1b)不同給藥途徑治療嬰幼兒毛細(xì)支氣管炎的有效性及安全性,為臨床用藥推薦合理的用藥途徑及用量。方法:選擇320例確診為毛細(xì)支氣管炎的患兒作為研究對象,其中對照組(A):霧化1組(B):霧化2組(C):肌注組(D)=1:1:1:1,每組80例。A組:對癥支持治療:根據(jù)病情給予解熱鎮(zhèn)痛藥、吸氧、霧化布地奈德(普米克令舒)+β2-受體激動劑/或M受體抑制劑。霧化組:對癥支持治療+rh IFN-α1b霧化吸入,將rh IFN-α1b溶入3ml生理鹽水,加入壓縮空氣式霧化器進(jìn)行治療,10-15分鐘/次,rh IFN-α1b用法為:B組:1μg/kg/次,2次/日,C組:2μg/kg/次,2次/日,每次用量不超過40μg。D組:對癥支持治療+1μg/kg/次rh IFN-α1b肌注,1次/日。比較臨床療效、臨床癥狀消失時間和療效指標(biāo)評分、住院時間、肺功能。同時觀察記錄不良反應(yīng)。結(jié)果:1、咳嗽癥狀緩解:1、咳嗽癥狀緩解:(1)d1:B組、C組、D組與A組比較,患兒咳嗽評分無統(tǒng)計學(xué)意義(F=1.283,P=0.280);(2)在d2、d3、d4、d5、d6、d7,B組、C組、D組與A組比較,咳嗽評分較低,其差異具有統(tǒng)計學(xué)意義(P0.05);(3)在d2、d3、d4、d5,B組、D組咳嗽評分較C組高,其差異具有統(tǒng)計學(xué)意義(P0.05);(4)在d2、d3、d4、d5、d6、d7,B組與D組咳嗽評分差異無統(tǒng)計學(xué)意義(P0.05)。在咳嗽緩解程度上,霧化組及肌注組明顯優(yōu)于對照組,而霧化2組效果更好。2、肺部哮鳴音緩解:(1)d1:B組、C組、D組與A組比較,患兒哮鳴音評分的差異無統(tǒng)計學(xué)意義(F=0.959,P=0.413);(2)d2、d3、d4、d5、d6、d7,A組哮鳴音評分較C組、D組高,差異具有統(tǒng)計學(xué)意義(P0.05);(3)d5、d6、d7,A組哮鳴音評分高于B組,其差異具有統(tǒng)計學(xué)意義(P0.05);(4)d2、d3、d4,C組哮鳴音評分高于D組其差異具有統(tǒng)計學(xué)意義(P0.05)。在哮鳴音緩解方面,霧化組、肌注組明顯優(yōu)于對照組,霧化2組、肌注組優(yōu)于霧化1組,而在治療前4天,霧化2組又優(yōu)于肌注組。3、三凹征緩解:(1)d1:A組、B組、C組、D組患兒三凹癥評分的差異無統(tǒng)計學(xué)意義(F=1.920,P=0.126);(2)d2、d3、d4、d5、d6、d7,A組三凹征評分較B組、C組、D組高,其差異具有統(tǒng)計學(xué)意義(P0.05);(3)d2、d3、d4、d5,B組、D組三凹征評分較C組高,其差異具有統(tǒng)計學(xué)意義(P0.05);(4)d2、d3、d4、d5、d6、d7,B組與D組三凹征評分差異無統(tǒng)計學(xué)意義(P0.05)。提示:霧化組、肌注組在緩解缺氧上優(yōu)于對照組,而在治療前5天,霧化2組優(yōu)于霧化1組及肌注組。4、退熱時間:(1)d1、d4、d5、d6、d7各組體溫的差異均無統(tǒng)計學(xué)意義(P0.05);(2)d2、d3:A組體溫較B組、C組、D組高,差異具有統(tǒng)計學(xué)意義(F=3.782,P=0.011);(3)d1、d2、d3、d4、d5、d6、d7,B組、C組、D組間體溫差異無統(tǒng)計學(xué)意義(P0.05)。干擾素霧化組、肌注組在退熱時間上短于對照組。5、肺功能改善:達(dá)峰時間比(Time to PTEF/expiratory time,TPEF/TE):(1)d1:各組TPEF/TE比值的差異無統(tǒng)計學(xué)意義(F=0.243,P=0.867);(2)d7:A組TPEF/TE比值較B組、C組、D組低,差異具有統(tǒng)計學(xué)意義(F=225.825,P0.001)。干擾素霧化組、肌注組在改善TPEF/TE上優(yōu)于對照組。達(dá)峰容積比(Expiratory volume at PTEF/expiratory volume,VPEF/VE):(1)d1:各組VPEF/VE比值的差異無統(tǒng)計學(xué)意義(F=2.040,P=0.108);(2)d7:A組VPEF/VE比值較B組、C組、D組低,差異具有統(tǒng)計學(xué)意義(F=271.321,P0.001)。干擾素霧化組、肌注組在改善VPEF/VE上優(yōu)于對照組。6、有效率及住院時間:(1)總有效率:A組有效率較B組、C組、D組低,差異具有統(tǒng)計學(xué)意義(F=12.015,P=0.007);(2)對RSV有效率:A組有效率較B組、C組、D組低,差異具有統(tǒng)計學(xué)意義(F=12.825,P0.001);(3)總住院天數(shù):A組住院天數(shù)較B組、C組、D組長,差異具有統(tǒng)計學(xué)意義(F=57.657,P0.001),其中D組較B組、C組住院時間短。干擾素霧化組、肌注組在總有效率、對RSV有效率、住院天數(shù)上優(yōu)于對照組,且霧化2組在住院天數(shù)上優(yōu)于霧化1組及肌注組。7、肝功能:四組在治療前后肝功能均在正常范圍內(nèi),未造成明顯肝功能損害。提示:干擾素治療對肝功能無明顯影響。結(jié)論:重組人干擾素α-1b對嬰幼兒毛細(xì)支氣管炎有明顯療效,且霧化吸入的效果優(yōu)于肌肉注射,可明顯促進(jìn)毛細(xì)支氣管炎患兒的臨床癥狀和生命體征恢復(fù),縮短病程,臨床療效顯著、安全,值得在臨床上進(jìn)一步推廣使用。
[Abstract]:Objective: To evaluate the efficacy and safety of recombinant human interferon alpha -1b (Recombinan human Interf--eron alpha -1b, Rh IFN- a 1b) in the treatment of infantile bronchiolitis, and to recommend rational drug use and dosage for clinical use. Methods: 320 cases of children with bronchiolitis were selected as the research object, and the control was used as the control. Group (A): atomization of 1 groups (B): atomization group (C): intramuscular group (D) =1:1:1:1, 80 cases in each group.A group: symptomatic support therapy: antipyretic analgesics, oxygen inhalation, atomization of budesonide (Pulmicort) + beta 2- receptor agonist / or M receptor inhibitor. Treatment with compressed air nebulizer, 10-15 minutes / time, Rh IFN- alpha 1b: B group: 1 mu g/kg/ times, 2 times / day, C group: 2 mu g/kg/, 2 times per day, each dosage is not more than 40 mu g.D group: symptomatic support treatment +1 mu g/kg/ sub RH IFN- alpha muscle injection, 1 times / day. Comparison of clinical efficacy, clinical symptoms vanishing time score score, stay time, hospitalization time, Lung function and observed adverse reaction. Results: 1, cough symptom relief: 1, cough symptom relief: (1) d1:B group, C group, group D and A group, the cough score is not statistically significant (F=1.283, P=0.280); (2) in D2, D3, D4, D5, D6, D7, group, and the difference has statistical significance; (3) The cough score of D4, D5, B and D was higher than that of the C group, and the difference was statistically significant (P0.05). (4) there was no significant difference in the cough score in D2, D3, D4, D5, D6, D7, and groups. The atomization group and the inject group were obviously better than the control group, but the effect of atomization group and the injection group was better than that of the control group, and the effect of atomization was better than that of the control group. (1) Group comparison, the difference of wheeze score of children was not statistically significant (F=0.959, P=0.413); (2) D2, D3, D4, D5, D6, D7, and A group was higher than C group and D group, and the difference was statistically significant (P0.05); (4) the difference had statistical significance. (4) the score of wheezing sounds was higher than that of the group. There was statistical significance (P0.05). In the alleviation of wheezing sound, the atomization group and the injection group were obviously superior to the control group. The atomization group was 2 groups and the inject group was superior to the nebulization group 1 groups, while at 4 days before the treatment, the atomization 2 groups were better than the intramuscular group.3 and three concave sign: (1) there was no statistical difference (F=1.920, P=0.126) in group d1:A, group B, C and D children (F=1.920, P=0.126); (2) D2, D3, D4, D5, D6, D7, A group three concave sign score was higher than B group, C group and D group, and the difference was statistically significant (P0.05); (3) D2, D3, D4, and three concave signs were higher than those of the group. (4) there was no significant difference between the three concave sign scores. 5 days before the treatment, the atomization 2 groups were better than the nebulization 1 groups and the inject group.4, and the fever time: (1) D1, D4, D5, D6, D7, the temperature difference was not statistically significant (P0.05); (2) D2, the body temperature of d3:A group was higher than that of B group, C group and D group. There was no statistical significance (P0.05). The IFN atomization group, the injection group was shorter than the control group.5, and the lung function was improved: the peak time ratio (Time to PTEF/expiratory time, TPEF/TE): (1) the TPEF/TE ratio of each group was not statistically significant (F=0.243, P=0.867), and (2) the ratio of d7:A group was lower than that of the group, and the difference was statistically significant. F=225.825 (P0.001). The IFN atomization group was better than the control group on the improvement of TPEF/TE. The peak volume ratio (Expiratory volume at PTEF/expiratory volume, VPEF/VE): (1) d1: VPEF/VE ratio was not statistically significant (F=2.040, 2), and the difference was statistically significant. 71.321, P0.001). The IFN atomization group was better than the control group.6, and the efficiency and time of hospitalization were better than the control group. (1) the total effective rate: the effective rate of group A was lower than that of B group, C group and D group (F=12.015, P=0.007), and (2) the efficiency of A group was lower than that in B group, group and group, and the difference was statistically significant. (3) total hospital days: the number of days in group A was more than that of group B, C group and D group, the difference was statistically significant (F=57.657, P0.001), among which group D was shorter than that of B group and C group. The efficiency of interferon atomization group and intramuscular injection was better than that of the control group, and the number of nebulization groups was superior to the nebulization group 1 groups and the.7, liver function in the hospital days. Four groups in the normal range of liver function before and after treatment, not causing obvious liver function damage. Hint: interferon therapy has no obvious effect on liver function. Conclusion: recombinant human interferon alpha -1b has obvious effect on infant bronchiolitis, and the effect of atomization inhalation is better than that of intramuscular injection, and it can obviously promote the children with bronchiolitis The clinical symptoms and vital signs recovered, the course of disease was shortened, the clinical effect was significant, safe, and worthy of further promotion in clinical practice.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.6
本文編號：2122755
[Abstract]:Objective: To evaluate the efficacy and safety of recombinant human interferon alpha -1b (Recombinan human Interf--eron alpha -1b, Rh IFN- a 1b) in the treatment of infantile bronchiolitis, and to recommend rational drug use and dosage for clinical use. Methods: 320 cases of children with bronchiolitis were selected as the research object, and the control was used as the control. Group (A): atomization of 1 groups (B): atomization group (C): intramuscular group (D) =1:1:1:1, 80 cases in each group.A group: symptomatic support therapy: antipyretic analgesics, oxygen inhalation, atomization of budesonide (Pulmicort) + beta 2- receptor agonist / or M receptor inhibitor. Treatment with compressed air nebulizer, 10-15 minutes / time, Rh IFN- alpha 1b: B group: 1 mu g/kg/ times, 2 times / day, C group: 2 mu g/kg/, 2 times per day, each dosage is not more than 40 mu g.D group: symptomatic support treatment +1 mu g/kg/ sub RH IFN- alpha muscle injection, 1 times / day. Comparison of clinical efficacy, clinical symptoms vanishing time score score, stay time, hospitalization time, Lung function and observed adverse reaction. Results: 1, cough symptom relief: 1, cough symptom relief: (1) d1:B group, C group, group D and A group, the cough score is not statistically significant (F=1.283, P=0.280); (2) in D2, D3, D4, D5, D6, D7, group, and the difference has statistical significance; (3) The cough score of D4, D5, B and D was higher than that of the C group, and the difference was statistically significant (P0.05). (4) there was no significant difference in the cough score in D2, D3, D4, D5, D6, D7, and groups. The atomization group and the inject group were obviously better than the control group, but the effect of atomization group and the injection group was better than that of the control group, and the effect of atomization was better than that of the control group. (1) Group comparison, the difference of wheeze score of children was not statistically significant (F=0.959, P=0.413); (2) D2, D3, D4, D5, D6, D7, and A group was higher than C group and D group, and the difference was statistically significant (P0.05); (4) the difference had statistical significance. (4) the score of wheezing sounds was higher than that of the group. There was statistical significance (P0.05). In the alleviation of wheezing sound, the atomization group and the injection group were obviously superior to the control group. The atomization group was 2 groups and the inject group was superior to the nebulization group 1 groups, while at 4 days before the treatment, the atomization 2 groups were better than the intramuscular group.3 and three concave sign: (1) there was no statistical difference (F=1.920, P=0.126) in group d1:A, group B, C and D children (F=1.920, P=0.126); (2) D2, D3, D4, D5, D6, D7, A group three concave sign score was higher than B group, C group and D group, and the difference was statistically significant (P0.05); (3) D2, D3, D4, and three concave signs were higher than those of the group. (4) there was no significant difference between the three concave sign scores. 5 days before the treatment, the atomization 2 groups were better than the nebulization 1 groups and the inject group.4, and the fever time: (1) D1, D4, D5, D6, D7, the temperature difference was not statistically significant (P0.05); (2) D2, the body temperature of d3:A group was higher than that of B group, C group and D group. There was no statistical significance (P0.05). The IFN atomization group, the injection group was shorter than the control group.5, and the lung function was improved: the peak time ratio (Time to PTEF/expiratory time, TPEF/TE): (1) the TPEF/TE ratio of each group was not statistically significant (F=0.243, P=0.867), and (2) the ratio of d7:A group was lower than that of the group, and the difference was statistically significant. F=225.825 (P0.001). The IFN atomization group was better than the control group on the improvement of TPEF/TE. The peak volume ratio (Expiratory volume at PTEF/expiratory volume, VPEF/VE): (1) d1: VPEF/VE ratio was not statistically significant (F=2.040, 2), and the difference was statistically significant. 71.321, P0.001). The IFN atomization group was better than the control group.6, and the efficiency and time of hospitalization were better than the control group. (1) the total effective rate: the effective rate of group A was lower than that of B group, C group and D group (F=12.015, P=0.007), and (2) the efficiency of A group was lower than that in B group, group and group, and the difference was statistically significant. (3) total hospital days: the number of days in group A was more than that of group B, C group and D group, the difference was statistically significant (F=57.657, P0.001), among which group D was shorter than that of B group and C group. The efficiency of interferon atomization group and intramuscular injection was better than that of the control group, and the number of nebulization groups was superior to the nebulization group 1 groups and the.7, liver function in the hospital days. Four groups in the normal range of liver function before and after treatment, not causing obvious liver function damage. Hint: interferon therapy has no obvious effect on liver function. Conclusion: recombinant human interferon alpha -1b has obvious effect on infant bronchiolitis, and the effect of atomization inhalation is better than that of intramuscular injection, and it can obviously promote the children with bronchiolitis The clinical symptoms and vital signs recovered, the course of disease was shortened, the clinical effect was significant, safe, and worthy of further promotion in clinical practice.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 許玉霞;廖先華;王斯;黃艷萍;;重組人干擾素α-1b不同給藥途徑治療嬰幼兒毛細(xì)支氣管炎的療效分析[J];川北醫(yī)學(xué)院學(xué)報;2016年05期
2 張學(xué)莉;黃英;趙艷;黃霞;王健;徐曉雯;何山;羅蓉;;重組人干擾素α2b霧化治療毛細(xì)支氣管炎近期療效與遠(yuǎn)期預(yù)后評價[J];中國實用兒科雜志;2016年09期
3 鄧遠(yuǎn)杰;王亞亭;李長春;;干擾素霧化吸入治療毛細(xì)支氣管炎療效及安全性Meta分析[J];安徽醫(yī)藥;2016年06期
4 周華;吉山寶;姜媛淵;車大鈿;;高滲鹽水霧化吸入治療嬰幼兒毛細(xì)支氣管炎臨床隨機對照試驗Meta分析[J];中國實用兒科雜志;2015年11期
5 劉學(xué)明;王月玲;甘凱;;靜脈用人血丙種球蛋白治療兒童重癥毛細(xì)支氣管炎的臨床效果[J];中國處方藥;2015年10期
6 郭梅;荊安龍;許峰;;普米克令舒、萬托林聯(lián)合甲強龍輔助治療小兒毛細(xì)支氣管炎的臨床研究[J];重慶醫(yī)學(xué);2015年25期
7 沈玉才;王斌;巢偉聰;許志松;鄺勇華;陳劍鋒;;經(jīng)鼻持續(xù)氣道正壓通氣優(yōu)先策略在重癥毛細(xì)支氣管炎中的應(yīng)用[J];實用醫(yī)學(xué)雜志;2015年17期
8 蘭常肇;王紅;馬少杰;;重組人干擾素α1b注射液霧化吸入治療兒童毛細(xì)支氣管炎療效及安全性分析[J];臨床和實驗醫(yī)學(xué)雜志;2015年16期
9 李小燕;王云;;微波聯(lián)合藥物治療小兒毛細(xì)支氣管炎的臨床觀察[J];包頭醫(yī)學(xué)院學(xué)報;2015年08期
10 史青竹;趙智;石新慧;韓根成;;Ⅰ型干擾素的抗病毒機制研究進(jìn)展[J];軍事醫(yī)學(xué);2015年07期
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