阿奇霉素替代激素治疗婴幼儿喘息性支气管炎临床研究

Clinical study of Azithromycin to substitute hormon in treatment of asthmatic bronchitis in infant

目的评价阿奇霉素治疗婴幼儿喘息性支气管炎的疗效并探讨其作用机制。方法婴幼儿喘息性支气管炎60例,随机分为2组,各30例,A组用阿奇霉素治疗,B组用地塞米松治疗,分别观察3d后的临床疗效;2组均测定其外周血清IL-4,IFN-γ浓度变化,并与15例健康婴幼儿（对照组）血清IL-4,IFN-γ浓度对比。结果A组与B组临床总有效率差异无统计学意义;整个喘息性支气管炎组与正常对照组相比IFN-γ和IL-4值差异均有统计学意义,IFN-γ下降,IL-4升高;各组治疗前与治疗后相比差异均有统计学意义,A组治疗后血清IFN-γ浓度增高、IL-4浓度下降;B组治疗后血清IFN-γ浓度下降、IL-4浓度也下降,且2组IFN-γ/IL-4值均显著升高。结论阿奇霉素治疗婴幼儿喘息性支气管炎有较好的疗效,能与地塞米松有同样的调节TH1及TH2细胞因子使之趋于平衡,并且有更好的促进细胞免疫作用。

Objective To evaluate the curative effect of Azithromycin in the treatment of asthmatic bronchitis in infant and to investigate their mechanism. Methods 60 cases of asthmatic bronchitis were randomized into group A and B （ n = 30 for each ）. A group was treated with Azithromycin, and B group was treated with hexadecadrol. Their clinical curative effects were observed after three days. Their peripheral serum IL-4 and IFN-γ levels were determined and compared with those of 15 healthy infants. Results Their overall effective rates of the two groups were not significant different. IFN-γ and IL-4 value of all asthmatic bronchitis groups had significant difference compared with normal control. There was significant difference between those before treatment and after treatment in each group. The IFN-γ level was increased while IL-4 level was decreased in group A,but the levels of both IFN-γ and IL- 4 in group B were decreased after treatment. IFN/IL-4 in both groups was significantly increased. Conlusion Azithromycin is effective in treating asthmatic bronchitis in infant, which has the same uniform regulative effect with hexadecadrol. Both can regulate the balance of IFN-γ and IL-4 cell factors and has preferable effect of promotive cell immunity.