高渗盐水联合干扰素雾化吸入治疗婴幼儿毛细支气管炎的疗效及其对免疫功能的影响

Hypertonic Saline Combined with Interferon Aerosol Inhalation in Children with Bronchiolitis and Its Influences to Immune Function

目的:观察高渗盐水联合干扰素雾化吸入治疗婴幼儿毛细支气管炎的疗效及其对患儿免疫功能的影响。方法:选取2014年9月至2015年9月于我院住院治疗的毛细支气管炎患儿426例,按随机数表法分为三组各142例。三组均给予重组人干扰素α1b雾化吸入,其中对照组联合注射用水,0.9%氯化钠溶液组联合0.9%氯化钠溶液,3%氯化钠溶液组联合3%氯化钠溶液。治疗前及治疗7 d后清晨采集空腹静脉血,测定T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、免疫球蛋白(Ig A、Ig G、Ig E、Ig M)水平。观察治疗后三组患儿临床体征恢复等情况及药物不良反应,判定临床疗效。结果:3%氯化钠溶液组的总有效率(93.66%)高于0.9%氯化钠溶液组(83.10%)与对照组(77.46%),且症状、体征改善时间均比其他两组更短(P均<0.05)。各组不良反应发生率比较差异均无统计学意义(P>0.05)。与治疗前相比,治疗后各组CD3+、CD4+、CD4+/CD8+及Ig E水平明显下降,Ig A及Ig G水平升高;3%氯化钠溶液组与其他两组相比,CD3+、CD4+、CD4+/CD8+及Ig E水平显著降低,CD8+、Ig A、Ig M及Ig G水平明显升高(P<0.05)。结论:3%高渗盐水联合干扰素雾化吸入可能通过协同促进细胞免疫和体液免疫治疗毛细支气管炎,疗效显著,不良反应少,且具有使用方便、患儿易接受等优点,值得临床推广。

Objective： To investigate the therapeutic effect of hypertonic saline combined with interferon aerosol inhalation in children with bronchilolitis and its influences to immune function. Methods： Four hundreds and twenty-six children with bronchiolitis who were admitted into our hospital from September 2014 to September 2015 were randomly divided into three groups（ 142 cases in each group）.All children were given recombinant human interferon α1b aerosol inhalation,while the 0. 9% sodium chloride solution group was combined with 0. 9% sodium chloride solution,3% sodium chloride solution group was combined with 3% sodium chloride solution,control group was combined with water for injection respectively. Fasted venous bloods were collected in the early morning before and after 7 days＇ treatment. T lymphocyte subsets（ CD3~＋,CD4~＋,CD8~＋,CD4~＋/ CD8~＋）,immunoglobulins（ IgA,IgG,IgE,IgM） in all groups before and after treatment were observed and compared. The clinical efficacy,improvement time of clinical symptoms,adverse reactions were recorded. Results： The total effective rate was 93. 66% in 3% sodium chloride solution group,which was significantly higher than that in 0. 9% sodium chloride solution group（ 83. 10%） and control group（ 77. 46%）（ P〈0. 05）. The improvement time of clinical symptoms in 3% sodium chloride solution group was also shorter than that in other groups（ P〈0. 05）. Adverse reactions had no statistically significant difference in all groups（ P〉0. 05）. After treatment,the proportions of CD3~＋,CD4~＋,CD4~＋/ CD8~＋and IgE were lower,but the levels of IgA and IgG were higher than those before treatment in three groups（ P〈0. 05）. Compared with the other two groups,the proportions of CD3~＋,CD4~＋,CD4~＋/ CD8~＋and IgE were significantly lower,and CD8~＋,IgA,IgM and IgG were obviously higher in 3% sodium chloride solution group（ P〈0. 05）. Conclusion： Hypertonic solution combined with interferon may synergistically improve celluler immunity and humoral immunity function with lower adverse reactions,which is effective in treating children with bronchiolitis,it is worthy of clinical application.