干扰素联合布地奈德雾化吸入治疗小儿RSV毛细支气管炎的疗效观察  

Observation on Curative Effect of Interferon Combined with Budesonide Nebulized Inhalation in Treatment of RSV Bronchiolitis in Children

作　　者：吴莹 徐济宝 汪丙松 WU Ying;XU Jibao;WANG Bingsong(Department of Pediatrics,Wuhu NO.1 People′s Hospital,Wuhu 241000,China)

机构地区：[1]芜湖市第一人民医院儿科,安徽芜湖241000

出　　处：《医学综述》2021年第18期3739-3744,共6页Medical Recapitulate

摘　　要：目的探讨干扰素联合布地奈德雾化吸入治疗小儿呼吸道合胞病毒(RSV)毛细支气管炎的临床疗效。方法选择2018年3月至2020年3月芜湖市第一人民医院收治的小儿RSV毛细支气管炎94例,依据治疗方法不同分为对照组和观察组,各47例。对照组患儿给予布地奈德雾化吸入治疗,每次1 mg,每日2次;观察组在对照组基础上结合重组人干扰素α1b雾化吸入治疗,每次300万IU/(kg·d),每日1次。两组疗程均为7 d。比较两组患儿的临床疗效,治疗前后肺功能[吸气呼气时间比(Ti/Te)、每千克体重潮气量(VT/kg)、呼吸阻力(Rrs)]、气道炎症[白细胞介素(IL)-4、γ干扰素(IFN-γ)、IL-10]和免疫功能指标变化,以及随访3个月内喘息发作情况。结果观察组总有效率高于对照组[95.75%(45/47)比78.72%(37/47)](P<0.05)。Ti/Te、VT/kg、Rrs的组间和时点间存在交互作用(P<0.01),观察组治疗后Ti/Te、VT/kg高于对照组,而Rrs低于对照组(P<0.05)。IL-4、IFN-γ和IL-10的组间和时点间存在交互作用(P<0.01),观察组治疗后血清IL-4水平低于对照组,IFN-γ、IL-10水平高于对照组(P<0.05)。CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)的组间和时点间存在交互作用(P<0.01),观察组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05)。随访3个月观察组喘息发生率低于对照组[4.25%(2/47)比21.28%(10/47)](P<0.05)。结论干扰素联合布地奈德雾化吸入治疗小儿RSV毛细支气管炎的效果显著,有助于减轻患儿气道炎症,增强免疫功能,减少喘息发作。Objective To investigate the clinical efficacy of interferon combined with budesonide nebulized inhalation in the treatment of respiratory syncytial virus(RSV)bronchiolitis in children.Methods Ninety-four children of RSV bronchiolitis admitted to Wuhu NO.1 People′s Hospital from Mar.2018 to Mar.2020 were included.According to different treatment methods,they were divided into a control group and an observation group,with 47 cases in each group.The control group was given budesonide nebulized inhalation treatment,1 mg each time,twice a day;the observation group was treated with aerosol inhalation of recombinant human interferonα1b on the basis of the control group′s regimen,3 million IU/(kg·d)each time,once a day.The course of treatment for both groups was 7 days.The clinical efficacy,lung function[inspiratory-expiratory time ratio(Ti/Te),tidal volume per kilogram of body weight(VT/kg),respiratory resistance(Rrs)],airway inflammation[interleukin(IL)-4,interferon-γ(IFN-γ),IL-10]and immune function indicators before and after treatment,as well as wheezing episodes within 3 months of follow-up of the two groups were compared.Results The total effective rate of the observation group was higher than that of the control group[95.75%(45/47)vs 78.72%(37/47)](P<0.05).There were interactions in Ti/Te,VT/kg and Rrs between groups and time points(P<0.01);after treatment,Ti/Te and VT/kg in the observation group were higher than those in the control group,while Rrs was lower than that in the control group(P<0.05).There were interactions in IL-4,IFN-γand IL-10 between groups and time points(P<0.01);after treatment,the serum IL-4 level in the observation group was lower than that in the control group,while the serum IFN-γand IL-10 levels were higher than those in the control group(P<0.05).There were interactions in CD3^(+)CD4^(+) and CD4^(+)/CD8^(+) between groups and time points(P<0.01);after treatment CD3^(+)CD4^(+),CD4^(+)/CD8^(+) in the observation group were higher than those in the control group(P<0.05).The incide

关 键 词：毛细支气管炎 呼吸道合胞病毒 布地奈德 重组人干扰素Α1B 喘息发作 气道炎症 免疫功能 

分 类 号：R725.6[医药卫生—儿科]