Journal of Developmental Medicine(Electronic Version)  2024, Vol. 12 Issue (5): 350-355 DOI: 10.3969/j.issn.2095-5340.2024.05.005 |
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| Curative effect of low-dose and long-course Azithromycin combined with inhaled corticosteroid on pediatric chronic bronchiolitis |
| Ma Qunying, Li Xuemei, Li Mingzhen, et al
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(Department of Pediatrics, Zigong First People's Hospital, Sichuan, Zigong 643000, China)
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Abstract 【Abstract】 Objective To explore the curative effect of low-dose and long-course Azithromycin combined with inhaled glucocorticoid (ICS) on pediatric chronic bronchiolitis. Method A total of 120 children withchronic bronchiolitis admitted to Zigong First People's Hospital were prospectively selected from January2021 to October 2022. According to random number table method, they were divided into control group(n=60) and observation group (n=60). Children in control group were given routine symptomatic treatmentand low-dose and long-course Azithromycin, while children in observation group were treated with ICS onbasis of control group. The curative effect, improvement time of clinical symptoms, serum immune functionindicators, serum inflammatory indicators and occurrence of adverse reactions in the two groups werecompared before and after treatment. All patients were followed up for 6 months after treatment to compareacute onset. Statistical methods performed by the independent sample t-test, paired sample t-test and χ2 test. Result The total effective rate of observation group was higher than that of control group [93.3% (56/60)vs 80.0% (48/60), χ2=4.615, P=0.032]. The remission time of wheezing, wet rale and cough in observationgroup and control group were (4.6±1.2) d, (7.3±1.9) d, (6.2±1.5) d and (5.2±1.5) d, (8.7±2.1) d,(6.9±1.6) d, and remission time of these symptoms in observation group were shorter than those in controlgroup (t=2.419, 3.826, 2.472, all P<0.05). After treatment, CD4+, CD8+ and CD4+/CD8+ in observation groupand control group were (39.6±4.3)%, (22.4±3.5)%, 1.7±0.4 and (32.3±3.5)%, (27.6±4.5)%, 1.2±0.4,respectively. CD4+ and CD4+/CD8+ in observation group were higher than those in control group (t=10.199,6.847, all P<0.001), while CD8+ was lower than that in control group (t=7.065, P<0.001). After treatment,granulocyte-macrophage colony stimulating factor (GM-CSF), soluble interleukin-2 receptor (SIL-2R) andserum interleukin-6 (IL-6) in observation group and control group were (731.6±224.6) mg/L, (239.1±58.5)mg/L, (39.6±4.0) ng/L and (962.5±262.5) mg/L, (287.3±62.4) mg/L, (44.6±4.3) ng/L, respectively. Thelevels of GM-CSF, SIL-2R and serum IL-6 in observation group were lower than those in control group(t=5.177, 4.365, 6.595, all P<0.001). There was no significant difference in the incidence of nausea andvomiting, lower abdominal pain and mild rash between observation group and control group (all P>0.05).After 6 months of follow-up, the acute onset rate of bronchiolitis in observation group was lower than that incontrol group [45.0% (27/60) vs 63.3% (38/60), χ2=4.062, P=0.044]. Conclusion Curative effect of lowdoseand long-course Azithromycin combined with ICS is significant on pediatric chronic bronchiolitis, which can effectively improve clinical symptoms, immune function, inflammation level and acute onset, with good
safety.
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Received: 05 June 2023
Published: 30 September 2024
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