羧甲淀粉钠对反复呼吸道感染患儿细胞及体液免疫功能的影响与疗效观察

Observation of the effect of Sodium Starch Glycolate in the treatment of children with recurrent respiratory tract infection and its influence on cellular and humoral immunologic function

目的 探讨羧甲淀粉钠对反复呼吸道感染（RRI）患儿细胞、体液免疫功能及疗效的影响.方法 选择RRI患儿50例（治疗组）予以羧甲淀粉钠溶液口服,连用12周.比较患儿治疗前后细胞及体液免疫功能的变化,并进行临床疗效及药物不良反应观察.选择同期儿内科门诊治疗的非RRI的急性呼吸道感染患儿30例作为对照组.结果 治疗组患儿治疗前血清CD4＋水平和CD4＋/CD8＋比值明显低于对照组,而CD8水平明显高于对照组（=2.27、2.25、2.91,P＜0.05或P＜0.01）.治疗12周后,患儿血清CD4＋水平和CD4＋/CD8＋比值明显上升,而CD8＋水平明显下降（t=2.12、2.17、2.43,均P＜0.05）.治疗组治疗前血清免疫球蛋白IgG、IgA和IgM水平明显低于对照组（=2.45、2.91、2.44,P＜0.05或P＜0.01）.治疗12周后,患儿血清IgG、IgA和IgM水平均明显上升（t=2.14、2.25、2.31,均P＜0.05）；治疗组患儿治疗12周后,总有效率高达96.0％ （48/50）,治疗期间未发生明显的药物不良反应事件.结论 羧甲淀粉钠治疗儿童RRI具有较好的效果及安全性,作用机制与调节T淋巴细胞亚群和免疫球蛋白水平紊乱,增强儿童的细胞和体液免疫功能密切相关.

Objective To explore the curative effect of Sodium Starch Glycolate on children with recurrent respiratory tract infection（RRI） and its influence on cellular and humoral immunologic function.Methods 50 RRI children were selected as treatment group and treated by Sodium Starch Glycolate orally for 12 weeks.The changes of cellular and humoral immunologic function before and after treatment,and the curative effect and adverse reaction were observed.Another 3 0 non RRI but ARI children who received outpatient medical treatment during the same period were selected as control group.Results Before treatment,the level of CD4＋ and CD4＋/CD8＋ of treatment group were significantly lower than that of control group,but the level of CD8＋ was the opposite（t =2.27,2.25,2.91,P ＜0.05 or P ＜0.01）.After treatment for 12 weeks,the level of CD4＋ and CD4＋/CD8＋ of treatment group increased significantly compared with before treatment,but the level of CD8＋ reduced significantly （t =2.12,2.17,2.43,all P ＜ 0.05）.The plasma levels of IgG,IgA and IgM of treatment group were significantly lower than those of the control group before treatment （t =2.45,2.91,2.44,P ＜ 0.05 or P ＜ 0.01）.After treatment for 12 weeks,the levels of IgG,IgA and IgM of treatment group increased significantly（t =2.14,2.25,2.31,all P ＜ 0.05）,and the total effective rate was up to 96.0％ （48/50）.No obvious adverse reaction occurred during treatment.Conclusion Sodium Starch Glycolate in treating RRI children shows good effect and high safety,which maybe relate with regulating the imbalance of the T cell subsets and immune globulin and enhancing the cellular and humoral immunologic function.