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目的评价用硫酸特布他林雾化液进行儿童肺功能支气管舒张试验的敏感性、特异性及安全性。方法对2016年3月至2016年6月在我院门诊及住院部就诊的反复喘息临床怀疑儿童支气管哮喘的患儿80例,随机分为试验组和对照组,试验组用Astra Zeneca AB生产的硫酸特布他林雾化液:体质量<20kg,1m L(2.5mg特布他林)+生理盐水1m L,体质量>20kg 2m L(5.0mg特布他林);对照组用深圳大佛药业有限公司生产的硫酸沙丁胺醇雾化溶液:6~8岁0.5m L(2.5mg沙丁胺醇)+生理盐水1.5m L,<12岁0.75m L(3.75mg沙丁胺醇)+生理盐水1.25m L,>12岁1m L(5.00mg沙丁胺醇)+生理盐水1m L。用德国百瑞牌空气压缩泵雾化吸入,吸入后15min重复测FEV1,以FEV1改善率增加≥12%为肺功能支气管舒张试验阳性;吸入支气管舒张剂前及试验结束后即刻记录患儿呼吸、心率、氧饱和度,试验结束还需观察患儿口咽刺激感、头晕头痛、骨骼肌震颤、心悸,并行心电图及血压监测。结果试验组及对照组患儿吸入支气管舒张剂后15min肺功能明显改善,与试验前肺功能比较差异有统计学意义(P<0.05);试验组患儿40例,支气管舒张试验阳性36例,阳性率为90.00%;对照组患儿40例,支气管舒张试验阳性37例,阳性率为92.50%,差异无统计学意义(P>0.05)。试验组患儿40例不良反5例,不良反应率12.50%;对照组40例不良反应10例,不良反应率25.00%;两组患儿均无心律紊乱、低血压、一过性低氧血症、皮疹等情况发生。两组患儿不良反应发生率差异无统计学意义(P>0.05)。结论用硫酸特布他林雾化液行儿童肺功能支气管舒张试验敏感性特异性强、安全性好,可在儿童肺功能支气管舒张试验中广泛运用。
Objective To evaluate the sensitivity, specificity and safety of terbutaline sulphate nebulization solution for bronchodilation in children with pulmonary function. Methods From March 2016 to June 2016 in our hospital outpatient and inpatient department of repeated wheezing clinical suspicion of children with bronchial asthma in 80 patients were randomly divided into experimental group and control group, the experimental group with Astra Zeneca AB production Terbutaline sulphate nebulizer: body weight <20kg, 1m L (2.5mg terbutaline) + saline 1m L, body weight> 20kg 2m L (5.0mg terbutaline); control group with the Shenzhen Buddha Pharmaceutical Co., Ltd. production of salbutamol sulfate atomization solution: 6 to 8 years old 0.5m L (2.5mg salbutamol) + saline 1.5m L, <12 years old 0.75m L (3.75mg salbutamol) + saline 1.25m L,> 12-year-old 1m L (5.00mg salbutamol) + saline 1m L. With Germany Bairui brand air compression pump inhalation inhalation after 15min repeated measurement of FEV1 to FEV1 improvement rate of ≥ 12% for pulmonary function bronchodilatation test positive; before inhalation of bronchodilator and immediately after the end of the test recorded breathing, Heart rate, oxygen saturation, the end of the trial also need to observe the sense of oropharyngeal irritation, dizziness, headache, skeletal muscle tremor, heart palpitations, ECG and blood pressure monitoring. Results The pulmonary function of the experimental group and the control group was significantly improved at 15 minutes after bronchodilator inhalation, with significant difference compared with that before the test (P <0.05); 40 cases in the test group, 36 cases of bronchial dilation test, The positive rate was 90.00%. There were 40 cases in control group and 37 cases in bronchodilator test, the positive rate was 92.50%. There was no significant difference (P> 0.05). There were 40 cases of adverse reactions in 5 cases in trial group with adverse reaction rate of 12.50%, 40 cases of adverse reactions in control group and 10 cases of adverse reaction rate. The adverse reaction rate was 25.00%. There was no arrhythmia, hypotension, transient hypoxemia Symptoms, rashes and other conditions occur. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusions The test of bronchodilator test in children with pulmonary vasospasm using atomization of terbutaline sulphate is sensitive and specific. It is safe and can be widely used in bronchodilation test of children with pulmonary function.