【摘要】 目的 探讨甲泼尼龙联合布地奈德治疗小儿感染性喉炎的疗效及其与血清C反应蛋白（CRP）、白细胞介素-4(IL-4)、IL-8水平的关系。方法 选择2018年1月-2020年12月于恩施土家族苗族自治州中心医院接受治疗的226例小儿感染性喉炎，采用随机数表法将其分为观察组（n=114）和对照组（n=112）。对照组给予布地奈德治疗，观察组在对照组的基础上加用甲泼尼龙治疗。比较两组疗效、CRP、IL-4、IL-8水平，临床症状改善时间及药物并发症情况。结果 治疗后，观察组总有效率为94.74%，高于对照组的84.82%，差异有统计学意义（χ~2=6.076,P=0.014）。治疗前两组CRP、IL-4、IL-8水平比较差异均无统计学意义（P均>0.05）；治疗后两组CRP、IL-4、IL-8水平较治疗前降低，且观察组CRP、IL-4、IL-8水平[（10.61±1.52）mg/L、（8.34±1.12）ng/L、（18.04±3.51）ng/L]低于对照组[（15.75±1.84）mg/L、（11.35±1.56）ng/L、（22.26±3.56）ng/L]，差异均有统计学意义（t=22.912、16.685、8.973,P均<0.05）。治疗后，观察组犬吠样咳嗽、声音嘶哑、喉鸣音、呼吸困难改善时间分别为（2.01±0.53）、（2.37±0.56）、（1.81±0.54）、（0.95±0.31）d，短于对照组的（3.28±0.64）、（3.95±0.74）、（3.18±0.76）、（1.64±0.44）d，差异均有统计学意义（t=16.259、18.119、15.643、13.647,P均<0.05）。两组不良反应主要为喉部刺激、面部潮红及恶心呕吐，观察组和对照组不良反应总发生率（4.39%vs. 3.57%）比较差异无统计学意义（P>0.05）。结论 在小儿感染性喉炎中甲泼尼龙联合布地奈德治疗有一定的治疗效果，可能与其可改善CRP、炎性损伤有关。更多还原

【Abstract】 Objective To study the efficacy of methylprednisolone combined with budesonide in the treatment of infective laryngitis in children and its relationship with serum levels of C-reactive protein(CRP),interleukin-4(IL-4),IL-8.Methods A total of 226 children with infective laryngitis treated in Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2018 to December 2020 were selected and divided into experimental group(n=114)and control group(n=112)by random number table method. The control group was treated with budesonide and the experimental group was treated with methylprednisolone on the basis of control group. The clinical efficacy,changes of CRP,IL-4 and IL-8levels,improvement of clinical symptoms and occurrence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate in the experimental group was 94.74%,which was higher than that of the control group(84.82%),the difference was statistically significant（χ~2=6.076,P=0.014）. There was no significant difference in the levels of CRP,IL-4 and IL-8 between the two groups before treatment(P all>0.05). After treatment,the levels of CRP,IL-4 and IL-8 in both groups were lower than those before treatment,and CRP,IL-4 and IL-8 in the experimental group[(10.61±1.52)mg/L,(8.34±1.12)ng/L,(18.04±3.51)ng/L]were lower than those in the control group[(15.75±1.84)mg/L,(11.35± 1.56)ng/L,(22.26± 3.56)ng/L],the differences were statistically significant(t=22.912,16.685,8.973;P all<0.05). After treatment,the improvement time of barking cough,hoarseness,throat sounds,breathing difficulties in the experimental group were(2.01±0.53),(2.37±0.56),(1.81±0.54),(0.95±0.31)d,respectively,which was shorter than those in the control group[(3.28±0.64),(3.95±0.74),(3.18±0.76),(1.64±0.44)d],the differences were statistically significant(t=16.259,18.119,15.643,13.647;P all<0.05). The main adverse reactions were laryngeal irritation,facial flushing,nausea and vomiting,and there was no significant difference in the total incidence of adverse reactions between the observation group and the control group(4.39% vs. 3.57%)(P>0.05). Conclusion Methylprednisolone had a certain therapeutic effect in pediatric infectious laryngitis,which might be related to the improvement of CRP and inflammatory injury.更多还原