匹多莫德口服液对小儿支原体肺炎外周血辅助性T细胞/CD4+CD25+Treg的影响  

Influence of pidotimod oral sodution on peripheral Th17/CD4 + CD25 + Treg of mycoplasma pneumonia in children

作　　者：冯乃超 雷智贤 钟丽花[1] 杨辉[1] FENG Nai-chao;ZHONG Li-hua;LEI Zhi-xian;YANG Hui(Department of Pediatrics,Maternity and Child Care Center of Hainan Province,Haikou 570206,Chin)

机构地区：[1]海南省妇幼保健院儿科,海口570206

出　　处：《中国临床药理学杂志》2018年第15期1785-1788,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的研究匹多莫德对小儿支原体肺炎Th17/CD4+CD25+Treg的影响。方法用随机数表将65例患儿分为试验组33例和对照组32例。2组均采用阿奇霉素进行序贯治疗,试验组额外给予匹多莫德口服液0.4 g·d^(-1),共治疗2周。对比2组患儿的临床疗效和药物不良反应(ADR)。抽取患者肘静脉血,用流式细胞法测定Th17/CD4+CD25+Treg,用酶联免疫吸附实验测定血清白细胞介素-17A(IL-17A)、转化生长因子β1(TGF-β_1)水平,用荧光定量PCR实验测定单个核细胞的维A酸相关孤独受体γt(RORγt)与叉头蛋白3(Foxp3)的mRNA表达。结果治疗后,试验组的有效率为90.9%(30例/33例),高于对照组的62.5%(20例/32例),差异有统计学意义(P<0.05)。治疗后,试验组Th17/CD4+CD25+Treg、IL-17A/TGF-β1及RORγt/Foxp3分别为0.97±0.18,1.25±0.21,1.49±0.21,对照组分别为1.25±0.20,1.69±0.26,1.68±0.18,试验组均低于对照组,差异均有统计学意义(P<0.01,P<0.05)。试验组与对照组ADR发生率分别为21.2%(7例/33例)和18.8%(6例/32例),2组差异无统计学意义(P>0.05)。结论匹多莫德能够调节支原体肺炎患儿Th17/CD4+CD25+Treg平衡,是其免疫学机制的重要组成部分。Objective To explore the influence of pidotimod on peripheral blood Th17/CD4 ＋ CD25 ＋ Treg of mycoplasma pneumonia in children. Methods Totally 65 children with mycoplasma pneumonia were divided into 2 groups： 33 cases of treatment group and 32 cases of control group. All the children were treated with azithromycin sequential therapy,at the same time,the children in treatment group were given pidotimod with 0. 4 g per day for 2 weeks. The clinical effect rate and adverse drug reactions（ ADR） were compared between 2 groups; furthermore,the elbow venous blood was extracted,and cell counting ratio of Th17/CD4 ＋ CD25 ＋ Treg cell county was detected by flow cytometry.The serum lever of interleukin-17 A（ IL-17 A）,transforming growth factor beta 1（ TGF-β_1） were detected by enzyme linked immunosorbent assay. The retinoid-related orphan receptor γt（ RORγt）,forkhead box protein 3（ Foxp 3） mRNA expression levels were detected by real-time and quantification PCR assay. Results After treatment,the effective rate of treatment group and control group were 90. 9 %（ 30 cases/33 cases）,62. 5%（ 20 cases/32 cases）,the difference in the treatment group higher than in the control group（ P 0. 05）. After treatment,the Th17/CD4 ＋ CD25 ＋ Treg,IL-17 A/TGF-β1 and RORγt/Foxp3 of treatment group were 0. 97 ± 0. 18,1. 25 ± 0. 21 and 1. 49 ± 0. 21,lower than those of control group which were 1. 25 ± 0. 20,1. 69 ± 0. 26,1. 68 ± 0. 18（ P 0. 01,P 0. 05）. The incidence of ADR in the 2 groups were 21. 2%（ 7 cases/33 cases）,18. 8%（ 6 cases/32 cases）,without significant difference（ P 0. 05）. Conclusion Pidotimod had the ability to regulate Th17/CD4 ＋ CD25 ＋ Treg balance of mycoplasma pneumonia children,which maybe one of its important mechanisms.

关 键 词：匹多莫德口服液 小儿 支原体肺炎 辅助性T细胞17 调节性T细胞 

分 类 号：R978.1[医药卫生—药品]