目的:探讨不同剂量氨溴索治疗婴幼儿百日咳的临床效果及安全性.方法:选取 2020 年 5 月—2022 年11月本院收治的 114 例婴幼儿百日咳患儿为研究对象,按照随机数字表法分为两组,各 57例.两组均予以拍背吸痰、面罩吸氧等对症治疗;在此基础上,对照组予以 7.5 mg氨溴索与 5%葡萄糖注射液混合静脉滴注,2 次/d;观察组给予10 mg氨溴索与5%葡萄糖注射液混合静脉滴注,2次/d.两组均持续治疗 14 d.观察两组患儿的临床疗效及临床症状持续时间,并比较治疗前、治疗 14d后两组患儿的咳嗽症状积分、炎症因子水平变化情况,统计两组患儿用药治疗后不良反应发生率.结果:观察组的临床治疗总有效率为 94.74%(54/57),高于对照组的 77.19%(44/57),差异有统计学意义(P<0.05).观察组的肺部啰音、痉挛性咳嗽、血氧饱和度下降持续时间及住院时间均显著短于对照组,差异有统计学意义(P<0.05).治疗前,两组患儿的咳嗽症状积分、血清白细胞介素-6(IL-6)、白细胞介素-17(IL-17)和肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,观察组的咳嗽症状积分、IL-6、IL-17和TNF-α均低于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率与对照组比较,差异无统计学意义(P>0.05).结论:相比于常规剂量,使用大剂量氨溴索治疗婴幼儿百日咳疗效更显著,安全性高,值得临床推广.
Objective:To investigate the clinical effect and safety of different doses of ambroxol in treating pertussis in in-fants.Methods:114 children with pertussis admitted to the hospital from May 2020 to November 2022 were selected as the study objects and divided into two groups according to the random number table method,with 57 cases in each group.Both groups were given symptomatic treatment,such as back patting,sputum suction,and oxygen inhalation by mask.Based on these,the control group was given 7.5 mg of ambroxol mixed with 5%glucose injection intravenously twice/d,while the obser-vation group was given 10 mg of ambroxol mixed with 5%glucose injection intravenously twice/d.Both groups were treated for 14 days.The clinical efficacy and duration of clinical symptoms in the two groups were observed,and the changes in scores of cough symptoms and levels of inflammatory factors in the two groups were compared before treatment and after 14 days of treatment.The incidence of adverse reactions after medication was calculated.Results:The total effective rate of the observation group was 94.74%(54/57),higher than that of the control group(77.19%,44/57).The difference was statistically significant(P<0.05).The duration of pulmonary rales,spastic cough,blood oxygen saturation decline,and hospital stay in the observation group were significantly shorter than those in the control group,with statistical significance(P<0.05).Before treatment,there was no statistically significant difference in the cough symptom score,serum interleukin-6(IL-6),interleukin-17(IL-17),and tumor necrosis factor-α(TNF-α)levels between the two groups(P>0.05).After treatment,the cough symptom score,IL-6,IL-17,and TNF-α in observation group were lower than those in the control group,with statistical significance(P<0.05).There was no significant difference in the total incidence of adverse reactions between the observation and control groups(P>0.05).Conclusion:Compared with the conventional dose,the efficacy and safety of high-dose ambroxol for treating pertussis in infants are more significant,and it is worthwhile to promote the use of this drug in clinical practice.