布地奈德雾化吸入对支原体肺炎患儿临床疗效及血清炎性因子水平的影响

Clinical Efficacy of Budesonide Aerosol Inhalation and Influence on Serum Inflammatory Factor Levels in Children with Mycoplasma Pneumonia

目的:探讨布地奈德雾化吸入治疗支原体肺炎患儿的临床疗效,以及对血清炎性因子水平的影响。方法:选择符合标准的患儿100例,根据入院先后顺序分为观察组和对照组各50例,两组患儿均给予常规治疗,观察组加用布地奈德雾化吸入,治疗期间观察患儿临床症状及体征的变化,治疗前及治疗7d检测血清中干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白介素-2(IL-2)、白介素-6(IL-6)、白介素-10(IL-10)和白介素-13(IL-13)水平。结果:观察组患儿治愈32例、显效14例、好转3例和无效1例;对照组患儿治愈25例、显效11例、好转9例和无效5例,差异有统计学意义(P<0.05)。观察组患儿发热、咳嗽、喘息及肺部啰音消失时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组患儿血清促炎因子IFN-γ、TNF-α、IL-6水平相似,差异无统计学意义(P>0.05);治疗7d后,两组患儿血清IFN-γ、TNF-α、IL-6水平较治疗前均下降,但观察组下降幅度更显著,差异有统计学意义(P<0.05)。治疗前,两组患儿血清抗炎因子IL-2、IL-10、IL-13水平相似,差异无统计学意义(P>0.05);治疗7d后,两组患儿血清IL-2水平较治疗前升高,IL-10、IL-13较治疗前降低,但观察组改善幅度更显著,差异有统计学意义(P<0.05)。结论:布地奈德雾化吸入能快速缓解支原体肺炎患儿临床症状和肺部体征,促使血清抗炎及促炎因子水平向正常状态下转化,提高临床治疗效果。

Objective： To investigate the clinical efficacy of budesonide aerosol inhalation and influence on serum inflammatory factor levels in children with myeoplasma pneumonia. Methods： Totally 100 eligible children were selected and randomly divided into observation group and control group according to the admission numbers, with 50 children in each group. Both groups were given conventional therapies, while the observation group used budesonide spray inhalation additionally. The changes in clinical symptoms and physical signs of the children were observed in the treatment period, and the serum levels of interferon-γ （ IFN-γ ） , tumor necrosis factor -α TNF- α ） , interleukin- 2 （ IL- 2 ） , interleukin- 6 （ IL- 6 ） , interleukin- 10 （ IL- 10） , and interleukin-β IL-β） were determined before treatment and after 7 d of treatment, respectively. Results： For the observation group, 32 children were cured, 14 children were responsive to the therapy excellently, 3 children were improved, and 1 child was unresponsive to the therapy; while for the control group, 25 children were cured, 11 children were responsive to the therapy excellently, 9 children were improved, and 5 children were unresponsive to the therapy; and the differences were statistically significant （P〈0.05）. The ob- servation group had significantly shorter times to disappearances of fever, cough, asthma, and tales in lungs than the control group （P〈0.05）. Before treatment, the two groups had insignificantly different serum levels of proinflammatory factors such as IFN-γ, TNF-α, and IL-6 （P 〉0.05） ; after 7 d of treatment, both groups had significantly decreased serum levels of IFN-γ, TNF-α, and 1L-6 compared with those before treatment, but the observation group had significantly greater decreasing extents than the control group （ P〈0.05 ）. Before treatment, the two groups had insignificantly different serum levels of antiinflammatory factors such as IL-2, IL-10, and IL-13 （P 〉0.05） ; after 7 d of treatment, both groups had significantly increased serum level of IL-2 and significantly decreased serum levels of IL-10 and IL-13 compared with those before treatment, but the observation group had significantly greater improving extents than the control group （ P 〈 0.05 ）. Conclusion： Budesonide aerosol inhalation can rapidly relieve the clinical symptoms and physical signs, promote nor- malization of serum levels of antiinflammatory and proinflammatory factors, and elevate the clinical efficacy in children with myeoplasma pneumonia.