灭活卡介苗治疗婴幼儿哮喘的临床疗效观察

Clinical efficacy inactivated BCG inoculation in infants with asthma

目的探讨灭活卡介苗经皮接种治疗婴幼儿哮喘的临床疗效。方法选择2001-07—2003-03于湖南省人民医院就诊的85例年龄9个月至3岁的哮喘婴幼儿,应用随机数目表法将来院就诊的患儿分为治疗组45例(应用灭活卡介苗组)和对照组40例。观察治疗前后免疫球蛋白E(IgE)、嗜酸性阳离子蛋白(ECP)、白细胞介素-4(IL-4)、γ-干扰素(IFN-γ)、纯结核蛋白衍生物(PPD)试验、哮喘的发作程度的变化及疗效的评价。结果与对照组比较,治疗组患儿IL-4、IFN-γ,ECP、PPD的变化有统计学意义(P<0·05),哮喘发作程度、临床疗效差异也存在显著性意义(P<0·01),临床总有效率为86.67%。结论灭活卡介苗经皮接种有明显的治疗作用,可作为防治婴幼儿哮喘的有效方法之一。

Objective To investigate the clinical value inactivated bacillus Calmette-Guerin（BCG） inoculation in infants with asthma,and to explore the effect between the constant stimulation by inactivated BCG inoculation and the asthma episode, Methods Forty-five young children with asthma aging from 9 months to 3 years,were included in this study. Serum levels of IgE and ECP were determined with enzyme linked fluoroimmunoassay by Phamacia CAP system. The concentrations of IFN-γ, IL-4 from peripheral blood mononuclear cells（ PBMC ）were measured using ELISA before and after inactivated BCG inoculation. PPD, the degree of the asthma episode and the clinical effect were followed after therapy. Forty infants with asthma receiving the the routine treatment served as the controls. Results After inactivated BCG inoculation for 6 months,the IFN-γ levels increased significantly from 16. 36±7. 10pg/L to 241.59 ± 111.25pg/L（ P 〈0. 01 ）. The IL-4 and ECP levels decreased significantly from 214. 36 ± 90. 88pg/L, 13.40 ± 20. 21 μg/L to 46. 13 ± 21.46pg/L,5.51±6.46μg/L （ P 〈0.05） respectively（ P 〈0.05）. PPD positive transformation increased from 15.6% to 93.3% after treatment. The degree of the asthma episode and the clinical effect changed significantly. Conclusion Inactivated BCG treatment may have significant clinical effect. The vaccine therapy will be aviailable to children with asthma.