布地奈德混悬液吸入对支原体肺炎患儿肺功能及炎性状态的影响

Effect of inhalation of budesonide suspension on pulmonary function and inflammatory status of children with mycoplasma pneumonia

目的:探讨布地奈德混悬液吸入治疗对小儿支原体肺炎患者血浆炎性细胞因子和肺功能的影响。方法:将82例支原体肺炎患儿随机分为观察组和对照组各41例。对照组患儿常规给予阿奇霉素静滴抗感染,并予止咳、化痰等对症治疗;观察组在此基础上给予布地奈德混悬液雾化吸入1周。于入院时、治疗1周后检测两组患儿外周血IFN-γ、IL-4含量,同时对两组患儿进行肺功能测试,包括用力肺活量(FVC)、第1秒用力肺活量(FEV1)和最大呼气流速(PEF)。结果:治疗前观察组和对照组IFN-γ含量分别为(5.72±1.76)pg/ml、(5.78±1.80)pg/ml,IL-4含量分别为(2.52±0.49)pg/ml、(2.51±0.49)pg/ml;治疗后两组IFN-γ含量均明显升高,观察组较对照组升高更明显(P<0.05);治疗后两组IL-4含量均明显降低,观察组较对照组降低更明显(P<0.05)。两组患儿治疗前均存在不同程度的混合性肺通气功能障碍,治疗1周后两组肺功能均明显改善,但观察组改善更明显。结论:布地奈德混悬液雾化吸入治疗小儿支原体肺炎可明显改善患儿的肺功能,缩短病程,作用机制可能与纠正外周血细胞因子的水平失调有关。

Objective：To explore the effect of inhalational therapy of budesonide suspension on plasma inflammatory cytokines and pulmonary function of children with mycoplasma pneumonia. Methods：Eighty-two children with mycoplasma pneumonia were randomly divided into observation group and control group,41 children in each group.The children in control group were treated with conventional intravenous drip of azithromycin for anti-infection,and symptomatic treatment was conducted,such as relieving cough and reducing phlegm;while the children in observation group were treated with inhalational therapy of budesonide suspension for one week based on the therapies used in control group.The contents of interferon-γ and interleukin-4 in peripheral blood samples of the children in the two groups were detected on admission and at one week after treatment,pulmonary function test was conducted in the two groups,the indexes included forced vital capacity（FVC）,forced vital capacity in one second（FEV1）,and peak expiratory flow（PEF）. Results：Before treatment,the contents of interferon-γ in observation group and control group were（5.72±1.76） pg/ml and（5.78±1.80） pg/ml,respectively;the contents of interleukin-4 in observation group and control group were（2.52±0.49） pg/ml and（2.51±0.49） pg/ml,respectively.After treatment,the contents of interferon-γ in the two groups increased significantly,especially in observation group（P0.05）;the contents of interleukin-4 in the two groups decreased significantly,especially in observation group（P0.05）.Before treatment,there were mixed pulmonary ventilation dysfunction at different levels in the two groups,pulmonary function in the two groups were improved significantly after treatment for one week,but the improvement in observation group was more obvious. Conclusion：Inhalational therapy of budesonide suspension can improve the pulmonary function of children with mycoplasma pneumonia,shorten the course of disease,and the mechanism may be correlated with correcting disorder of cytokines levels in peripheral blood.