乙酰半胱氨酸雾化联合肺泡灌洗术对大叶性肺炎患儿炎症吸收时间及血清CRP、LDH、D-D水平的影响

摘要 目的：观察乙酰半胱氨酸雾化联合肺泡灌洗术对大叶性肺炎患儿炎症吸收时间及血清C反应蛋白（CRP）、乳酸脱氢酶（LDH）、D-二聚体（D-D）水平的影响。方法：选取2021年1月~2022年12月我院收治的大叶性肺炎患儿80例，以随机数字表法将患儿分成对照组（n=40）与联合组（n=40）。给予对照组患儿肺泡灌洗术治疗，联合组则在对照组基础上予以乙酰半胱氨酸雾化治疗。比较两组患儿临床疗效、临床症状改善情况，治疗前后的肺功能[1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、呼气峰值流速（PEF）]及血清学指标水平。结果：经过治疗后联合组临床疗效的总有效率为92.50%，显著高于对照组的75.00%（P<0.05），且联合组患儿肺部炎症吸收时间、咳嗽缓解时间及退热时间均显著少于对照组（P<0.05）。此外，治疗后两组患儿的FEV₁、FVC及PEF均较治疗前升高，且联合组高于对照组（P＜0.05）；CRP、LDH及D-D水平均较治疗前降低，且联合组低于对照组（P<0.05）。结论：乙酰半胱氨酸雾化联合肺泡灌洗术治疗大叶性肺炎患儿疗效确切，可显著缓解临床症状，缩短炎症吸收时间，同时能显著改善患儿肺功能，降低血清炎性因子水平。

Effects of Acetylcysteine Nebulization Combined with Alveolar Lavage on Inflammatory Absorption Time, Serum CRP, LDH and D-D in Children with Lobar Pneumonia

ABSTRACT Objective: To observe the effects of acetylcysteine nebulization combined with alveolar lavage on inflammatory absorption time, levels of serum C-reactive protein (CRP), lactate dehydrogenase (LDH) and D-dimer (D-D) in children with lobar pneumonia. Methods: A total of 80 children with lobar pneumonia admitted to the hospital were enrolled between January 2021 and December 2022. According to random number table method, they were divided into control group (n=40) and combination group (n=40). The control group was treated with alveolar lavage, while combination group was additionally treated with acetylcysteine nebulization. The clinical curative effect, improvement of clinical symptoms, lung function [forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), peak expiratory flow(PEF)] and serological indexes in the two groups were compared before and after treatment. Results: After treatment, total response rate of clinical curative effect in combination group was significantly higher than that in control group (92.50% vs 75.00%, P<0.05), absorption time of lung inflammation, relief time of cough and antipyretic time were significantly shorter than those in control group (P<0.05). After treatment, FEV₁, FVC and PEF in both groups were increased, which were higher in combination group than control group(P<0.05), while levels of CRP, LDH and D-D were decreased, which were lower in combination group than control group(P<0.05). Conclusion: The curative effect of acetylcysteine nebulization combined with alveolar lavage is significant on children with lobar pneumonia, which can significantly relieve clinical symptoms, shorten inflammatory absorption time, significantly improve lung function and reduce levels of serum inflammatory factors.