卡介苗多糖核酸与减毒活卡介苗治疗哮喘患儿疗效比较及治疗前后细胞因子的变化  

Comparison of Effects of Bacille Calmette-Guerin-Polysaccharide-Nucleic Acid and Attenuated Bacille Calmette-Guerin Therapy on Children with Asthma and Changes of Cytokines from Peripheral Blood Mononuclear Cells before and after Treatment

作　　者：田庆玲[1] 金江[2] 庞保东[1] 吴家骅[1] 刘瑞兰[1] 刘凤珍[1] 张慧玉[1] 刘树平[1] 

机构地区：[1]唐山市妇幼保健院,河北唐山063000 [2]河北医科大学第四附属医院,石家庄050011

出　　处：《实用儿科临床杂志》2006年第16期1072-1073,1079,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨卡介苗多糖核酸(BCG-PSN)与减毒活卡介苗治疗儿童哮喘临床疗效及其对哮喘患儿TH1/TH2调节的差异。方法急性发作期哮喘患儿60例随机分A、B、C3组,每组20例。A组予全球哮喘防治创议(GI NA方案)+BCG-PSN0.5mg/次,肌注,1次/隔日,共36次;B组予GI NA方案+减毒活卡介苗0.1mL,皮内注射,仅1次;C组单纯GI NA方案治疗。酶联法检测治疗前后血清IgE及外周血单个核细胞(PBMC)诱生的IL-4、IL-5及IFN-γ。结果1.疗效:A组优于B组,B组优于C组(P均<0.05)。2.治疗组治疗后IFN-γ均高于治疗前,IL-4、IL-5、IgE均低于治疗前。对于调整IL-5,A组优于B组和C组(P<0.05,0.01);对于上调IFN-γ及下调IL-4、IgE,A与B组比较无显著差异(P>0.05)。结论1.BCG-PSN的疗效优于减毒活卡介苗。2.减毒活卡介苗一次性小剂量接种对哮喘儿IL-4、IFN-γ、IgE失衡的调节与BCG-PSN多次肌注效果相当,对IL-5失衡的调节不及BCG-PSN。Objective To study the functions of two different kinds of drugs on regulating TH1/TH2 of children with asthma by comparing the effects of bacille calmette - guerin - polysaccharide - nucleic acid （ BCG - PSN） and attenuated BCG. Methods Study groups were ,selected from 60 cases of acute asthmatic children, group A（20 cases） was treated with BCG- PSN combined with GINA therapy, group 13 （20 cases） was treated with attenuated BCG combined with GINA therapy, and group C（20 cases） with GINA therapy alone. Levels of IL - 4, IL- 5, IFN - γ derived from peripheral blood mononuclear cells （PBMC） and serum lgE measured with ELISA were monitored before and 10 - 12 weeks after treatment. Results 1. Clinical treating effect ： group A was better than group B, group B was better than group C （all P〈0.05）. 2. Level of IFN - γ in each study groups after treatment were higher than that before treatment, le-vels of IL- 4 , IL- 5, lgE were lower than those before treatment. In the change of IL- 5, group A was better than that of group B （P〈0.05） and group C（P〈0.01）. In the changes of IL-4 , IFN-γ, lgE , there were no difference between group A and group B. Conclusions 1. The clinical effect of intramuscular injection of BCG - PSN several times is better than clinical effect with intradermal injection of attenuated BCG once. 2. Vaccinating attenuated BCG once with small amount has almost the same effect as intramuscular injection of BCG - PSN several times in regulating the levels of IL - 4, IFN - γ, lgE, but has not as good as the latter in regulating the level of IL- 5.

关 键 词：卡介苗多糖核酸 卡介苗 哮喘 儿童 细胞因子 治疗 

分 类 号：R725.6[医药卫生—儿科]