阿奇霉素联合布地奈德对支原体肺炎患儿细胞因子、共刺激分子和免疫功能的影响  

Effects of azithromycin combined with budesonide therapy on the serum cytokines,co-stimulatory molecules and immune function in children patients with mycoplasma pneumonia

作　　者：庞卫花[1] 李金巍 宗广帅 曹智丽[2] 陈珊[1] 林晓燕[3] 杨敬芳[1] PANG Weihua;LI Jinwei;ZONG Guangshuai(Department of Clinical Laboratory, The Second Hospital Affiliated to Hebei North College, Hebei,Zhangjiakou 075100, China)

机构地区：[1]河北北方学院附属第二医院检验科,河北省张家口市075100 [2]河北北方学院附属第二医院传染科,河北省张家口市075100 [3]河北北方学院附属第二医院儿科,河北省张家口市075100

出　　处：《河北医药》2020年第3期362-365,共4页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展攻关计划项目(编号:1821031D)

摘　　要：目的观察阿奇霉素联合布地奈德对支原体肺炎(MPP)患儿细胞因子、共刺激分子和免疫功能的影响。方法选取2013年10月至2016年6月诊治的MPP患儿110例,随机分为对照组和观察组,每组55例。2组均给予阿奇霉素治疗,观察组在对照组基础上加用布地奈德,疗程2周。观察2组临床疗效、症状消失时间及治疗前后肺功能(FVC、FEV1、PEF)、血清细胞因子(IL-4、IL-17、IL-18、IFN-γ)、sB7-H3、T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、免疫球蛋白(IgA、IgG、IgM)变化。结果观察组总有效率明显高于对照组,症状消失时间明显短于对照组(P<0.05)。治疗前2组FVC、FEV1、PEF、血清IL-4、IL-17、IL-18、IFN-γ、CD3+、CD4+、CD8+、IgA、IgG、IgM及CD4+/CD8+比较差异无统计学意义(P>0.05);治疗后2组FVC、FEV1、PEF、血清CD3+、CD4+、IgA、IgG、IgM及CD4+/CD8+均明显高于治疗前,血清IL-4、IL-17、IL-18、IFN-γ、sB7-H3、CD8+均明显低于治疗前,差异有统计学意义(P<0.05),且2组差异有统计学意义(P<0.05)。结论阿奇霉素联合布地奈德治疗MPP疗效确切,能够明显降低患儿血清细胞因子、共刺激分子水平,改善患儿肺功能和免疫功能,值得临床推广应用。Objective To investigate the effects of azithromycin combined with budesonide therapy on the serum cytokines,co-stimulatory molecules and immune function in children patients with mycoplasma pneumonia(MPP).Methods A total of 110 children patients with MPP who were admitted and treated in our hospital from October 2013 to June 2016 were enrolled in the study,who were randomly divided into observation group(n=55)and control group(n=55).The patients in both groups were treated by azithromycin,on that basis,the patients in observation group were treated by budesonide,with a treatment course of two weeks for both groups.After treatment,the clinical curative effects,to the disappearance time of clinical symptoms,pulmonary function(FVC,FEV1,PEF),serum cytokines(IL-4,IL-17,IL-18,IFN-γ),sB7-H3,T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)and immune globulin(IgA,IgG,IgM)were observed and compared between the two groups.Results The total effective rate in observation group was significantly higher than that in control group,and the disappearance time of clinical symptoms in observation group was significantly shorter than that in control group(P<0.05).Before treatment there were no significant differences in FVC,FEV1,PEF and serum IL-4,IL-17,IL-18,IFN-γ,sB7-H3,CD3+,CD4+,CD8+,CD4+/CD8+,IgA,IgG and IgM between the two groups(P>0.05).After treatment,the levels of FVC,FEV1,PEF,serum CD3+,CD4+,IgA,IgG,IgM and CD4+/CD8+were significantly increased in both groups,as compared with those before treatment,however,the serum levels of IL-4,IL-17,IL-18,IFN-γ,sB7-H3,CD8+were significantly decreased in both groups(P<0.05).Moreover the improvement degree of above indexes in observation group was more significant than that in control group(P<0.05).Conclusion The azithromycin combined with budesonide in treatment of MPP in children patients can significantly reduce the levels of cytokines and co-stimulatory molecules,improve pulmonary function and immune function of patients,therefor,it is worthy of clinical application and promotion.

关 键 词：阿奇霉素 布地奈德 支原体肺炎 细胞因子 共刺激分子 免疫功能 

分 类 号：R563.13[医药卫生—呼吸系统]