布地奈德雾化吸入联合阿奇霉素对支原体肺炎患儿肺功能及血清炎症因子、免疫功能的影响

Effect on pulmonary function,serum inflammatory factors and immune function of budesonide spray inhalation combined with azithromycin in children with mycoplasma pneumonia

目的：观察布地奈德雾化吸入联合阿奇霉素对支原体肺炎（MPP）患儿肺功能及血清炎症因子、免疫功能的影响。方法：选取2014年6月～2016年5月我科住院的MPP患儿128例,随机分为观察组（68例）和对照组（60例）。对照组给予阿奇霉素,观察组在对照组的基础上给予布地奈德雾化吸入治疗。2周后,观察两组肺功能指标肺活量（FVC）、第1秒最大呼气量（FEV1）、最高呼气峰流速（PEF）及用力呼气25%时瞬时流量（PEF25）,血清炎症因子肿瘤坏死因子（TNF-α）、白介素-6（IL-2）、白介素-6（IL-6）、干扰素-γ（INF-γ）及免疫功能指标（IgM、IgG、IgA）的变化。结果 ：（1）两组FEV1、FVC、PEV及PEF25均较本组治疗前明显上升（P〈0.05）,且观察组治疗后FEV1、FVC、PEV及PEF25分别为（1.89±0.45）L、（76.56±8.35）%、（2.67±0.87）L/s、（1.37±0.34）L/s,均高于对照组,差异均有统计学意义（P〈0.05）;（2）两组TNF-α、IL-2、IL-6及INF-γ均较本组治疗前下降（P〈0.05）,且观察组治疗后TNF-α、IL-2、IL-6及INF-γ分别为（4.32±2.71）、（189.26±44.16）、（8.31±4.43）、（16.23±2.68）ng/L,均低于对照组,差异均有统计学意义（P〈0.05）;（3）治疗后,两组IgM、IgA下降而IgG上升（P〈0.05）,且观察组低于对照组,差异均有统计学意义（P〈0.05）。结论：布地奈德雾化吸入联合阿奇霉素治疗儿童MPP能显著改善肺功能,抑制炎症反应、调节免疫功能作用更强,优于单用阿奇霉素。

Objective： To observe the effect on pulmonary function,serum inflammatory factors and immune function of budesonide spray inhalation combined with azithromycin in children with mycoplasma pneumonia （MPP）. Methods： A total of 128 cases of children with MPP who were treated in our department from June 2014 to May 2016 were randomly divided into the observation group （68 cases） and the control group （60 cases）.The control group was given azithromycin,and the observa- tion group was given budesonide spray inhalation based on the control group. After 2 weeks, to observe the differences of pul- monary function （FVC, FEV1, PEV, PEF25）, Serum inflammatory factors （TNF-α, IL-2, IL-6, INF-7） and Immune function （IgM, IgG, IgA）, between the two groups. Results： （DAfter treatment, FVC,FEV1 ,PEV and PEF25 of the two groups were increased with before （P〈0.05）, the observation group were lowed greater than those of the control group, with significant difference（P〈0.05） ; After treatment, TNF-α, IL-2,IL-6 and INF-γof the two groups were increased with before （P〈0. 05）, the observation group were higher than those of the control group, with significant difference（P 〈0.05）; After treat-ment, IgM, IgA of the two groups were decreased and IgG were increasedwith before （P〈0.05） ,the observation group were lowed greater than those of the control group, with significant difference （P〈0.05）. Conclusions： Budesonide spray inhalation combined with azithromycin can significantly improve pulmonary function in treatment of children with MPP, and has stronger effect of inhibiting inflammatory reaction and regulating the immune function,which are better than single azithromycin.