细菌溶解产物对支气管哮喘合并反复呼吸道感染患儿血清β防御素1及免疫球蛋白的影响

Influence of OM-85 BV on hBD-1 and immunoglobulin in children with asthma and recurrent respiratory tract infection

目的 探讨细菌溶解产物治疗支气管哮喘合并反复呼吸道感染患儿的临床疗效及其对血清人β-防御素-1（hBD-1）和免疫球蛋白（Ig）等物质的影响。方法 采用随机、双盲法将2011年1~12月期间患支气管哮喘合并反复呼吸道感染的62例患儿分成两组，在进行规范的吸入糖皮质激素治疗的同时分别给予细菌溶解产物或安慰剂治疗，观察两组患儿临床疗效及治疗前、治疗6个月和12个月后血清各指标水平及可能出现的不良反应。血清hBD-1应用酶联免疫吸附法（ELISA）检测；血清IgA、IgG、IgM应用免疫比浊法检测；尿素（UREA）和丙氨酸氨基转移酶（ALT）分别用酶速率法和速率法检测。结果 与安慰剂组及治疗前比较，细菌溶解产物组治疗6个月及12个月后呼吸道感染次数均明显减少（均P〈0．05）；与安慰剂组及治疗前比较，细菌溶解产物组治疗6个月及12个月后血清hBD-1、IgA、IgG浓度均显著升高（均P〈0．05）；IgM、UREA和ALT浓度在两组间和治疗前后比较差异均无统计学意义（P〉0．05）。两组患儿共发生不良反应3例，其中腹痛2例，便秘1例，程度均较轻。结论细菌溶解产物治疗支气管哮喘合并反复呼吸道感染患儿具有有效性和安全性，可提高hBD-1、IgA、IgG水平，减少急性呼吸道感染的发生。

Objective To observe the clinical therapeutic effect of OM-85 BV（OM-85 Broncho-Vaxom） in children with asthma and recurrent respiratory tract infection, and the effect of OM-85 BV on human β-defensins 1 （hBD-1） and immunoglobulin levels. Methods Sixty-two children with asthma and recurrent respiratory infection treated between 2011 January and December were divided into two groups by the randomized, double blind method： a treatment group and a control group. With inhaling corticosteroids, the treatment group was given OM-85 BV, and the control group was given a placebo. Clinical curative effects and adverse reactions were observed. Serum levels of hBD-1, IgA, IgG, IgM and urea and alanine aminotransferase （ALT） were measured before treatment and 6 months and 12 months after treatment. Results Compared with the control group and before treatment, the frequency of respiratory tract infection was reduced in the treatment group 6 months and 12 months after treatment （P〈0.05）, and serum levels of hBD-I, IgA and IgG in the treatment group increased significantly （P〈0.05）. There was no significant difference in serum levels of urea, ALT and IgM between the control and treatment groups （P〉0.05）. Mild adverse reactions occurred in 3 cases in the two groups, 2 cases of abdominal pain and 1 cases of constipation. Conclusions OM-85 BV can improve serum levels of hBD-1, IgA and IgG, reduce the occurrence of acute respiratory tract infection and cause mild adverse reactions, suggesting its satisfactory therapeutic effect and safety in the treatment of asthma combined with recurrent respiratory tract infection in children.