目的 探討丙酸氟替卡松聯(lián)合阿奇霉素對(duì)肺炎支原體感染所致慢性咳嗽患者的肺功能、呼出一氧化氮（FeNO）和炎癥因子的影響。方法 選取在2018年3月-2019年3月就診于北京市通州區(qū)婦幼保健院普兒科門診的肺炎支原體感染所致慢性咳嗽的患兒96例作為對(duì)象，隨機(jī)將患兒分為對(duì)照組（n=48例）和觀察組（n=48例）。對(duì)照組口服阿奇霉素干混懸劑，10 mg/（kg·d），連續(xù)服用3 d，停藥4 d，視為1個(gè)療程，連續(xù)治療2個(gè)療程。觀察組在對(duì)照組基礎(chǔ)上聯(lián)合丙酸氟替卡松吸入氣霧劑治療，丙酸氟替卡松吸入氣霧劑連接儲(chǔ)霧罐霧化，100 μg/次，早晚各1次，連續(xù)治療14 d。比較兩組患者治療前后的肺功能、FeNO、炎癥因子及藥物安全性。結(jié)果 治療后，兩組肺功能1s用力呼氣容積（FEV1）、肺活量（FVC）水平高于治療前（P<0.05）；觀察組FEV₁/FVC水平低于治療前（P<0.05）；治療后，觀察組FEV1、FVC及FEV₁/FVC水平高于對(duì)照組（P<0.05）。兩組治療后FeNO、IL-6、TNF-α水平低于治療前（P<0.05）；觀察組治療后FeNO、IL-6、TNF-α水平顯著低于對(duì)照組（P<0.05）。兩組用藥治療過(guò)程中不良反應(yīng)發(fā)生率無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 丙酸氟替卡松聯(lián)合阿奇霉素用于肺炎支原體感染所致小兒慢性咳嗽能提高患兒肺功能水平，能降低FeNO及炎癥因子水平，藥物安全性較高，值得推廣應(yīng)用。

Objective To investigate the effect of fluticasone propionate combined with azithromycin on patients with chronic cough caused by mycoplasma pneumonia, and its effect on lung function, FeNO, and inflammatory factors. Methods A total of 96 children with chronic cough caused by mycoplasma pneumoniae infection in Tongzhou Maternal & Child Health Hospital of Beijing from March 2018 to March 2019 were selected as subjects, and they were randomly divided into control group (48 cases) and observation group (48 cases). Children in the control group were po administered with Azithromycin for Suspension, 10 mg/(kg·d) for 3 consecutive days, and the drug was discontinued for 4 days, which was considered as 1 course of treatment, and children were treated for 2 courses. Children in the observation group was treated with Fluticasone Propionate Inhaled Aerosol on the basis of the control group. Fluticasone Propionate Inhaled Aerosol was connected to the storage tank and atomized 100 μg/time, one time in the morning and one time in the evening for 14 d. After treatment, the levels of lung function, FeNO, inflammatory factors, and drug safety in two groups before and after treatment were compared. Results After treatment, the levels of FEV1, FVC in two groups were significantly increased (P<0.05), FEV1/FVC in the observation group were decreased (P<0.05), and the levels of FEV1, FVC, and FEV1/FVC in the observation group were higher than those in the control group (P<0.05). After treatment, FeNO, IL-6, and TNF-α levels in two groups were significantly decreased, and the levels of FeNO, IL-6, and TNF-α were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions during the treatment of the two groups was not statistically significant.Conclusion Fluticasone propionate combined with azithromycin for chronic cough caused by mycoplasma pneumoniae infection in children can improve the level of lung function, reduce the level of FeNO and inflammatory factors, the drug is safe and worthy of promotion.

R974

北京市衛(wèi)生與健康科技成果和適宜技術(shù)推廣項(xiàng)目（2018-TG-69）