甲泼尼龙联合克拉霉素治疗闭塞性细支气管炎的疗效及其对患儿MMP-9、TIMP-1的影响  

Clinical efficacy of methylprednisolone combined with clarithromycin in the treatment of patients with bronchiolitis obliterans and its effect on MMP-9, TIMP-1

作　　者：丁淑玉[1] 李亚伟[1] 杨新丽[1] 闫海燕 杨惠卫 

机构地区：[1]保定市第二中心医院儿科,河北保定072750

出　　处：《海南医学》2017年第18期2948-2951,共4页Hainan Medical Journal

摘　　要：目的探讨甲泼尼龙联合克拉霉素治疗对闭塞性细支气管炎(BO)患儿基质金属蛋白酶-9(MMP-9)、金属蛋白酶抑制剂-1(TIMP-1)表达的影响。方法回顾性分析2011年5月至2016年5月在保定市第二中心医院儿科治疗的31例BO患儿的临床资料,按照治疗方案不同分为观察组(甲泼尼龙+克拉霉素)17例和对照组(甲泼尼龙)14例,观察两组患儿临床疗效、治疗后康复时间、治疗前后血清MMP-9和TIMP-1水平变化以及治疗期间不良反应发生情况。结果观察组和对照组患儿的治疗总有效率(100.00%vs 78.60%)比较,观察组明显高于对照组,差异有统计学意义(P<0.05);观察组和对照组患儿的咳嗽/喘息平均消失时间[(6.19±0.77)d vs(7.40±0.85)d]、气促/吸气性三凹症平均消失时间[(7.10±0.69)d vs 8.42±0.76)d]、平均退热时间[(8.35±1.06)d vs(12.02±1.17)d]、平均住院时间[(15.28±3.26)d vs(18.97±3.50)d]比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05);观察组和对照组患儿的血清MMP-9[(1 366.26±20.97)ng/mL vs(1 504.07±21.30)ng/mL]及MMP-9/TIMP-1[(5.12±0.94)vs(5.48±1.01)]比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05);两组患儿治疗期间不良反应发生率(17.65%vs14.29%)比较,差异无统计学意义(P>0.05)。结论甲泼尼龙联合克拉霉素治疗BO效果显著,其可有效改善患儿临床症状和血清MMP-9和TIMP-1水平,且不良反应发生率低,可作为优选治疗方案。Objective To explore the clinical efficacy of methylprednisolone combined with clarithromycin in the treatment of patients with bronchiolitis obliterans （BO） and its effect on matrix metalloproteinase-9 （MMP-9）, tissue inhibitor of metalloproteinase-1 （TIMP-1） of the patients. Methods Thirty-one patients with BO treated in the Second Central Hospital of Baoding from May 2011 to May 2016 were assigned into observation group （treated with methylpred-nisolone combined with clarithromycin, 17 cases） and control group （treated with methylprednisolone, 14 cases）. The clinical efficacy, recovery time, MMP-9, TIMP-1 levels before and after treatment, and adverse reactions were ob-served. Results The total effective rate in the observation group were significantly higher than that in the control group, （100.00%vs 78.60%, P〈0.05）. The time for disappearance of cough/gasp, time for disappearance of anhelation/three depression sign, defervescence time and length of hospital stay were （6.19±0.77） d, （7.10±0.69） d, （8.35±1.06） d, （15.28±3.26） d in the observation group, versus （7.40±0.85） d, （8.42±0.76） d, （12.02±1.17） d, （18.97±3.50） d in the con-trol group （P〈0.05）. The level of MMP-9 and MMP-9/TIMP-1 were （1366.26 ± 20.97） ng/mL and （5.12 ± 0.94） in the observation group, significantly lower than （1504.07 ± 21.30） ng/mL and （5.48 ± 1.01） in the control group （P〈0.05）. There was no significant difference in the rate of adverse reactions between the two groups （17.65% vs 14.29%, P〉0.05）. Conclusion Methylprednisolone combined with clarithromycin has significant efficacy in the treatment of pa-tients with bronchiolitis obliterans. It can improve the clinical symptoms and the levels of MMP-9 and TIMP-1, with very few adverse reactions, which can be used as the preferred treatment.

关 键 词：闭塞性细支气管炎 甲泼尼龙 克拉霉素 基质金属蛋白酶-9 金属蛋白酶抑制剂-1 

分 类 号：R725.6[医药卫生—儿科]