关键词: N-乙酰半胱氨酸, 小儿, 下呼吸道肺炎支原体感染, 临床疗效, 炎症因子

Abstract: Objective To explore the clinical effect of N-acetylcysteine (NAC) nebulization in the adjuvant treatment of mycoplasma pneumoniae infection of pediatric lower respiratory tract and its influences on levels of inflammatory factors, improving the treatment level of mycoplasma pneumoniae infection in children's lower respiratory tract. Methods Eighty-six children with mycoplasma pneumoniae infection of lower respiratory tract who were admitted to Hubei Maternal and Child Health Care Hospital during the period from October 2018 to October 2019 were enrolled as the research objects. They were divided into observation group (n=43) and control group (n=43) by random number table method. The control group was treated with routine treatment, while observation group was treated with NAC nebulization for adjuvant therapy. The clinical curative effect, recovery situations, levels of inflammatory factors before and after treatment, and incidence of adverse reactions were compared between the two groups. Results The effective rate of clinical treatment in observation group was higher than that in control group (90.70% vs 74.42%) (χ²=3.95, P=0.04). The returning to normal time of body temperature, disappearance time of cough and hospitalization time in observation group were significantly shorter than those in control group [(3.05±0.86)d, (5.12±1.14)d, (8.46±1.05)d vs (3.64±1.03)d, (5.83±1.76)d, (10.17±1.32)d] (t=2.88, P=0.01, t=2.22, P=0.03, t=6.65, P<0.001). After treatment, level of interferon γ(INF-γ) in observation group was significantly higher than that in control group [(31.14±6.05) pg/ml vs (27.96±5.34) pg/ml] (t=2.58, P=0.01). After treatment, levels of tumor necrosis factor α(TNF-α) and interleukin 4 (IL-4) in observation group were significantly lower than those in control group [(24.69±5.27) ng/L, (30.57±5.37) pg/ml vs (28.92±4.83) ng/L, (33.88±5.86) pg/ml] (t=3.88, P<0.001, t=2.73, P=0.01). There was no significant difference in incidence of adverse reactions between observation group and control group (9.30% vs 13.95%) (χ²=0.46, P=0.50). Conclusions The application of NAC nebulization in the adjuvant treatment of children with mycoplasma pneumoniae infection of lower respiratory tract can improve clinical curative effect, significantly improve clinical uncomfortable symptoms, and regulate the expression of inflammatory factors.

Key words: N-acetylcysteine, Child, Mycoplasma pneumoniae infection of lower respiratory tract, Clinical curative effect, Inflammatory factor