特布他林联合阿奇霉素序贯疗法对肺炎支原体肺炎患儿TLR4/MyD88/NF-κB通路的影响  

Effect of terbutaline combined with azithromycin sequential therapy on TLR4/MyD88/NF-κB pathways of children with Mycoplasma pneumoniae pneumomnia

作　　者：刘景[1] 张景岚 胡靖 王菲[1] LIU Jing;ZHANG Jing-lan;HU Jing;WANG Fei(Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou,Henan 450018,China)

机构地区：[1]郑州大学附属儿童医,院河南省儿童医院,郑州儿童医院介入医学&血管瘤科,河南郑州450018

出　　处：《中华医院感染学杂志》2025年第2期265-269,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230566)。

摘　　要：目的探讨特布他林联合阿奇霉素序贯疗法(AZST)对肺炎支原体肺炎患儿Toll样受体4/髓样分化因子88/核因子κB(TLR4/MyD88/NF-κB)通路的影响,为临床治疗肺炎支原体肺炎提供参考。方法随机选取62例2020年10月—2023年10月郑州儿童医院收治的肺炎支原体肺炎患儿,随机数字表法分为AZST组和AZST联合特布他林组,每组31例。入院后AZST组常规治疗后给予AZST治疗,AZST联合特布他林组在AZST基础上予以硫酸特布他林雾化液治疗,总疗程为7~10 d。比较两组治疗后的临床疗效,分析患儿肺功能、炎症指标、心肌酶谱及TLR4/MyD88/NF-κB通路相关蛋白表达水平,记录治疗期间不良反应发生情况。结果两组患儿临床疗效率比较有统计学差异(Z=2.379,P=0.017);与AZST治疗比较,特布他林联合AZST治疗疗效率更高,肺功能指标水平升高更明显,炎症指标水平下调明显,心肌酶谱指标水平降低更明显;治疗后,两组患儿血清TLR4、MyD88、NF-κB水平降低差值比较有统计学意义(P<0.05),其中AZST联合特布他林组TLR4、MyD88、NF-κB降低差值分别为(3.77±0.59)pg/ml、(4.59±0.61)pg/ml、(3.81±1.14)pg/ml;两组不良反应发生率无统计学差异(χ^(2)=1.449,P=0.229)。结论特布他林联合AZST治疗肺炎支原体肺炎可有效改善患儿炎症和心肌酶谱指标水平,调控TLR4/MyD88/NF-κB通路,进而有利于提高临床疗效,改善肺功能,安全性良好。OBJECTIVE To explore the effect of terbutaline combined with azithromycin sequential therapy(AZST)on Toll-like receptor 4/myeloid differentiation factor 88/nuclear factorκB(TLR4/MyD88/NF-κB)pathways of the children with Mycoplasma pneumoniae pneumonia so as to provide guidance for clinical treatment of M.pneumoniae pneumonia.METHODS A total of 62 children with M.pneumoniae pneumonia who were treated in Zhengzhou Children′s Hospital from Oct.2020 to Oct.2023 were enrolled in the study and were randomly divided into the AZST group and the AZST combined with terbutaline group,with 31 cases in each group.After the admission to the hospital,the AZST group to be treated with AZST after conventional treatment,and the AZST combined with terbutaline group was given atomized liquid of terbutaline sulfate on the basis of AZST.The total treatment course ranged between 7 and 10 days.The clinical curative effect was compared between the two groups,the levels of lung function indexes,inflammatory factors,myocardial enzymes and TLR4/MyD88/NF-κB pathway-related proteins were observed and compared between the two groups,and the incidence rates of adverse reactions during the treatment course were recorded.RESULTS There was significant difference in the effective rate of clinical treatment between the two groups of children(Z=2.379,P=0.017).The effective rate of treatment of the AZST combined with terbutaline group was higher than that of the AZST group,the levels of lung function indexes of the AZST combined with terbutaline group were remarkably higher than those of the the AZST group,the levels of inflammatory indexes of the AZST combined with terbutaline group were significantly lower than those of the AZST group,and the levels of myocardial enzyme indexes of the AZST combined with terbutaline group were remarkably lower than those of the AZST group.There were significant differences in the reduced levels of serum TLR4,MyD88 and NF-κB between the two groups of children after the treatment(P<0.05);the reduced level of TLR4

关 键 词：肺炎支原体肺炎 特布他林 阿奇霉素序贯疗法 心肌酶谱 Toll样受体4 髓样分化因子88 核因子κB 

分 类 号：R563.1[医药卫生—呼吸系统]