布地奈德联合沙丁胺醇雾化吸入对急性哮喘发作患儿诱导痰液炎性细胞和细胞因子的影响

Influence of inhaled Budesonide and Salbutamol on inflammatory cells and cytokines concentrations in induced sputum from children with acute asthma

目的布地奈德(普米克令舒)联合沙丁胺醇雾化吸入治疗儿童哮喘急性发作前后气道炎性细胞、白介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)的变化,探讨其影响机制。方法对急性哮喘发作患儿采用上述联合治疗1周,共对34例急性发作期、24例缓解期患儿和15例正常儿童的诱导痰液进行炎性细胞计数和分类,测定其中IL-6、IL-8、TNF-α水平。结果急性组的总白细胞数,嗜酸粒细胞、中性粒细胞单核细胞比例及IL-6、IL-8、TNF-α水平均高于正常对照组。缓解组除嗜酸粒细胞及淋巴细胞比例明显高于正常对照组外,其余上述炎性细胞比例及细胞因子水平均降至正常。结论普米克令舒联合沙丁胺醇雾化吸入可显著降低急性哮喘发作患儿气道分泌物内嗜酸粒细胞、中性粒细胞和单核细胞数量及IL-6、IL-8、TNF-α水平。

Objective To investigate the influence of inhaled Budesonide and Salbutamol on inflammatory cells and cytokines concentrations in induced sputum from children with acute exacerbation of asthma. Methods Children with acute asthma were treated with inhaled Budesonide and Salbutamol for one week. Children with acute asthma underwent sputum induction,and sputum induction was repeated when the children had recovered. Induced sputums were also taken from 15 healthy children as the controls. Total and differential cell counts were performed. Interleukin-6 （ IL-6）, IL- 8 and tumor necrosis factor α （TNF-α） were detected. Results Total WBC count,eosinophils,neutrophils,macrophages,IL-6,IL-8,TNF-α level in acute asthma group were higher than that of normal control group. In remission group except that eosinophils and lynhocytes remained a higher percentage compared with those of normal control group, the abore other in flammatory cells and cytokines were reduced to a normal percentage or level. Conclusions Therapy of inhaled Budesonide and Salbutamol can reduce inflammatory cells and cytokines concentrations in induced sputum from children with an acute exacerbation of asthma.