2021 年第 4 期 第 16 卷

复方异丙托溴铵联合布地奈德对支气管哮喘患儿血管内皮生长因子与转化生长因子β1和单核细胞趋化蛋白4水平及肺功能的影响

Effects of compound ipratropium bromide combined with budesonide on vascular endothelial growth factor, transforming growth factor-β1, monocyte chemoattractant protein-4 levels and pulmonary function in children with bronchial asthma

作者：张蓓1杨召川2王增兰3宋爱琴1

英文作者：Zhang Bei1 Yang Zhaochuan2 Wang Zenglan3 Song Aiqin1

单位：1青岛大学附属医院儿科重症医学科266003；2青岛大学附属医院儿童保健科266003；3山东省淄博市市级机关医院检验科255000

英文单位：1Department of Pediatric Critical Care Medicine the Affiliated Hospital of Qingdao University Qingdao 266003 China; 2Department of Child Health the Affiliated Hospital of Qingdao University Qingdao 266003 China; 3Department of Laboratory Zibo Municipal Government Hospital Shandong Province Zibo 255000 China

关键词：支气管哮喘；复方异丙托溴铵；布地奈德；血管内皮生长因子；转化生长因子β1

英文关键词：Bronchialasthma;Compoundipratropiumbromide;Budesonide;Vascularendothelialgrowthfactor;Transforminggrowthfactor-β1 

• 摘要：

• 目的 分析复方异丙托溴铵联合布地奈德对支气管哮喘患儿血清血管内皮生长因子（VEGF）、转化生长因子β1（TGF-β1）、单核细胞趋化蛋白4（MCP-4）水平及肺功能的影响。方法 选取2019年1月至2020年2月青岛大学附属医院儿科收治的100例支气管哮喘患儿，根据随机数字表法分为对照组和观察组，各50例。对照组采用布地奈德雾化吸入进行治疗，观察组使用布地奈德联合复方异丙托溴铵雾化吸入进行治疗，2组均治疗14 d。比较2组治疗14 d后的疗效和治疗期间症状消失时间，比较2组治疗前和治疗14 d后血清VEGF、TGF-β1、MCP-4水平和肺功能。结果 治疗14 d后，观察组总有效率高于对照组［94.0%(47/50)比76.0%(38/50)］（P＜0.05）。治疗期间，观察组咳嗽、气喘和喘鸣音消失时间较对照组显著缩短（均P＜0.05）。治疗14 d后与治疗前比较，2组血清TGF-β1、VEGF、MCP-4水平均降低，且观察组均低于对照组（均P＜0.05）。治疗14 d后，2组用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、峰值呼气流速均较治疗前升高，且观察组均高于对照组，观察组FEV1/FVC较治疗前升高，且高于对照组（均P＜0.05）。结论 复方异丙托溴铵联合布地奈德对支气管哮喘患儿进行治疗，能显著降低患儿血清VEGF、TGF-β1、MCP-4水平，抑制疾病进展，缓解临床症状，同时改善患儿肺功能，具有良好的治疗效果。

• Objective To analyze the effects of compound ipratropium bromide combined with budesonide on vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), monocyte chemoattractant protein-4(MCP-4) levels and lung function in children with bronchial asthma. Methods From January 2019 to February 2020, 100 children with bronchial asthma in the Affiliated Hospital of Qingdao University were selected. They were randomly divided into control group and observation group, with 50 cases in each group. The control group was treated with budesonide inhalation, while the observation group was treated with budesonide combined with compound ipratropium bromide inhalation. Both groups were treated for 14 d. The efficacy after 14 d of treatment and symptom disappearance time during treatment were compared between the two groups, and the levels of serum VEGF, TGF-β1, MCP-4 and lung function were compared before and after 14 d of treatment. Results After 14 d of treatment, the total effective rate in the observation group was higher than that in the control group［94.0%(47/50) vs 76.0%(38/50)］(P＜0.05). During the treatment, the disappearance time of cough, asthma and wheezing in the observation group were significantly shorter than those in the control group (all P＜0.05). Compared with those before treatment, the levels of serum TGF-β1, VEGF and MCP-4 in the two groups decreased after 14 d of treatment, and those in the observation group were lower than those in the control group (all P＜0.05). After 14 d of treatment, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEF) of the two groups were significantly higher than those before treatment, and those in the observation group were higher than those in the control group; FEV1/FVC in the observation group was higher than that before treatment and higher than that in the control group (both P＜0.05). Conclusion Compound ipratropium bromide combined with budesonide in treatment of bronchial asthma can significantly reduce serum VEGF, TGF-β1, MCP-4 levels, inhibit disease progression, relieve clinical symptoms, and improve lung function of children with good therapeutic effect.