标题：不同剂量复方异丙托溴铵雾化吸入对支气管哮喘患儿疗效及心率的影响

      作者：林冬丽，蔡旭俊，谢少君    (汕头市澄海区人民医院儿科，广东 汕头 515800)

      卷次： 2017年28卷11期

      【摘要】 目的 探讨不同复方异丙托溴铵雾化吸入对支气管哮喘患儿疗效及心率的影响。方法 选择我院儿科于 2014年 6月至 2016年 6月期间收治的 84例支气管哮喘患儿，根据随机数字表法分为A、B、C三组，每组28例，所有患儿均接受雾化吸入复方异丙托溴铵治疗，剂量分别为每次 1 mL、1.25 mL、2.5 mL，疗程 7 d；比较三组患儿的临床疗效及首次用药后的心率情况。结果 A组患儿的治疗总有效率为 71.43%，明显低于 B组的89.29%和C组的 96.43%，差异均有统计学意义(P<0.05)，而B组和C组的疗效比较差异无统计学意义(P>0.05)；在治疗后 5 min、20 min，心率在三组均较治疗前显著加快，且在A组、B组、C组间分别为(108.5±9.6)次/min和(104.8±7.5)次/min、(117.2±8.9)次/min和(110.5±8.1)次/min、(124.8±9.2)次/min和（126.6±9.7）次/min，两两比较均依次上升，差异有统计学意义(P<0.05)；A组与B组心率恢复正常时间分别为(21.6±6.2) min、(24.4±6.8) min，差异无统计学意义(P>0.05)。结论 复方异丙托溴铵雾化吸入治疗儿童支气管哮喘急性发作具有较好的临床疗效，选择1.25 mL的中剂量复方异丙托溴铵雾化吸入治疗可以在保证疗效的前提下减少对患儿心率的影响。
      【关键词】 支气管哮喘；复方异丙托溴铵；不良反应；心率
      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2017）11—1768—03

Dose-related effects of combined ipratropium bromide and salbutamol inhalation aerosol in children withbronchial asthma on therapeutic efficacy and heart rate.
LIN Dong-li, CAI Xu-jun, XIE Shao-jun. Department ofPediatrics, People's Hospital of Chenghai District of Shantou City, Shantou 515800, Guangdong, CHINA
【Abstract】 Objective To explore the dose-related effects of combined ipratropium bromide and salbutamol in-halation aerosol in children with bronchial asthma on therapeutic efficacy and heart rate. Methods A total of 84 chil-dren with bronchial asthma hospitalized in our hospital's Department of Pediatrics from June 2014 to June 2016 were ran-domly divided into A, B, C groups (28 cases in each group) according to the random number table method, who weretreated with ipratropium bromide/salbutamol through inhaling at different dosage (1 mL, 1.25 mL, 2.5 mL per time, re-spectively) via nebulizer for 7 days. The therapeutic efficacy and the heart rate of first drug use were compared amongthree groups. Results The total effective rate of A group was 71.43%, significantly lower (P<0.05) than that of B group(89.29%) and C group (96.43%); while no significant difference was found between B group and C groups (P>0.05). Ip-ratropium bromide/salbutamol inhalation for 5 min and 20 min increased the heart rate significantly than before treat-ment in all three groups. Mean heart rate after treatment were (108.5±9.6) times/min and (104.8±7.5) times/min in Agroup, (117.2±8.9) times/min and (110.5±8.1) times/min in B group, (124.8±9.2) times/min and (126.6±9.7) times/min inC group; there were significant differences found in all the paired groups (P<0.05). The heart rate recovery time of A groupand B group were (21.6±6.2) min and (24.4±6.8) min, respectively, with no significant difference between groups (P>0.05). Conclusion Ipratropine bromide and salbutamol inhalation has better clinical efficacy in the treatment of childrenwith acute bronchial asthma. Based on the premise of ensuring the curative effect, a medium-dose (1.25 mL) of ipratropinebromide and salbutamol inhalation treatment can reduce the effect on heart rate in children.
      【Key words】 Bronchial asthma; Combined ipratropium bromide and salbutamol; Adverse reaction; Heart rate·论 著·doi:10.3969/j.issn.1003-6350.2017.11.016