哮喘儿童吸入糖皮质激素治疗前后血清总IgE的变化  

Changes of Serum Total Immunoglobulin E before and after Glucocorticoid Inhalation in Children with Asthma

作　　者：李云[1] 钟礼立[1] 黄寒[1] 王涛[1] 易红玲[1] 梁沫[1] 陈敏[1] 张亮[1] 

机构地区：[1]湖南省人民医院儿科,长沙410005

出　　处：《实用儿科临床杂志》2008年第16期1249-1251,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨哮喘儿童吸入糖皮质激素(ICS)治疗前后血清总IgE的变化及意义。方法选择2005年12月-2007年11月本院儿童哮喘门诊哮喘患儿351例。诊断标准参照全国儿童哮喘协作组标准。随机分为对照组(118例),ICS组(233例)。对照组主要以非特异性免疫调节剂治疗为主。ICS组<5岁(162例)患儿选用储雾罐吸入氟替卡松气雾剂(辅舒酮),≥5岁(71例)患儿选用沙美特罗替卡松粉吸入剂(舒利迭)。对照组与ICS组分别于治疗前和治疗3个月运用全自动过敏原定量分析仪测定其血清IgE,ICS组继续治疗至1a,复查测定其血清IgE水平。结果对照组治疗前及治疗3个月IgE水平分别为(360.14±34.43)ng/L、(385.07±32.36)ng/L(P>0.05);ICS组治疗前、治疗3个月及1aIgE分别为(586.26±42.39)ng/L、(453.12±30.74)ng/L、(421.96±25.73)ng/L,治疗前与治疗3个月比较有显著差异(t=4.744P<0.01),治疗3个月与治疗1a比较无明显差异(t=1.384P>0.05)。ICS治疗3个月,辅舒酮治疗者(162例)中107例(66.05%)控制,舒利迭治疗者(71例)中52例(73.24%)控制,二组比较无明显差异(P>0.05)。辅舒酮治疗者中126例(77.78%)IgE水平下降,舒利迭治疗者中43例(60.56%)IgE下降,二组比较差异有显著性意义(P<0.01)。结论ICS氟替卡松治疗儿童哮喘中等剂量可使血清IgE下降,IgE的检测有利于哮喘患儿诊治过程中的体内变态反应状况的观察。IgE下降在哮喘急性期明显,缓解期下降缓慢。二种不同剂型的ICS均能有好的临床疗效,但在降低血清IgE水平方面,舒利迭则不及辅舒酮。Objective To explore the changes of serum total IgE before and after glucocorticoid inhalation in children with asthma and its significance.Methods Three hundred and fifty-one asthmatic children were selected from our hospital between Dec.2005 and Nov.2007 were selected.The diagnosis had been carried out following the nationwide cooperation standard of childhood asthma.The patients were categorized into the inhaled corticosteroids（ICS） treated group（n=233） and control group（n=118）.The nonspecific immunity regulator was mainly used in control group.Within the ICS group,fluticasone aerosol contained in metered dose inhaler（MDI） was used via a spacer by the patients who were no more than 5 years old（162 cases）,and advair diskus was used by patients who were more than 5 years old（71 cases）.During the treatment,the patients of the 2 groups were followed up for 3 months to compare the total IgE levels before and after treatment.However,the ICS group continued being treatment and were observed up to 1 year.Results Before and after 3 months treatment,the serum total IgE of control group were（360.14±34.43） ng/L,（385.07±32.36） ng/L.As to the ICS group before treatment,after 3 months treatment,and after 1 year treatment,the serum total IgE were（586.26±42.39） ng/L,（453.12±30.74） ng/L and（421.96±25.73） ng/L,restectively.There were significant difference of total IgE after treatment 1 year was compared with that before treatment（t=4.744 P〈0.01）,and compared with that of 3 months treatment（t=1.384 P〉0.05）.After 3 months treatment in the ICS group,there were 107 out of 162（66.05%） patients whose symptoms were controlled by the therapy of the MDI containing fluticasone aerosol;and there were 52 out of 71（73.24%） patients whose symptoms were controlled by the therapy of advair diskus.Therefore,there was no significant difference in clinical performance between 2 groups（P〉0.05）.After the treatment of 2 dosage,the serum total IgE of 126 patients（77.78%） h

关 键 词：哮喘 吸入糖皮质激素 免疫球蛋白E 变态反应 氟替卡松 儿童 

分 类 号：R725.6[医药卫生—儿科]