小剂量糖皮质激素联合大环内酯类药物对MP致咳嗽变异性哮喘血清细胞因子水平影响

Effect of Low-Dose Glucocorticoid Combined with Macrolides on Levels of Serum Cytokines in Patients with Mycoplasma Pneumoniae-Induced Cough Variant Asthma

目的 研究小剂量糖皮质激素联合大环内酯类药物对肺炎支原体（mycoplasma pneumonia,MP）致咳嗽变异性哮喘血清细胞因子水平影响.方法 选取我院2013年4月至2016年4月122例MP致咳嗽变异性哮喘患儿为研究对象,将纳入患儿抽签随机分为联合组与常规组,每组61例.联合组给予小剂量布地奈德与阿奇霉素治疗,常规组给予阿奇霉素治疗,比较临床疗效、血清细胞因子、肺功能指标以及不良反应发生率.结果 联合组治疗后的血清免疫球蛋白E（IgE）、肿瘤坏死因子α（TNF-α）分别为（152.38＆#177;23.94）ng/L、（15.18＆#177;6.37）ng/L显著低于常规组的（201.26＆#177;32.75）ng/L、（20.58＆#177;9.64）ng/L（P〈0.05）;联合组治疗后的转化生长因子β1（TGF-β1）、肺活量（FVC）分别为（69.28＆#177;23.13）ng/L、（3.65＆#177;0.88）L显著高于常规组的（47.16＆#177;20.33）ng/L、（3.12＆#177;0.95）L（P〈0.05）.结论 小剂量布地奈德联合阿奇霉素可以通过调节咳嗽变异性哮喘患儿血清TGF-β1、IgE、TNF-α等细胞因子,减轻气道高反应性,改善临床症状与肺功能.

Objective To study the effect of low-dose glucocorticoid combined with macrolides on levels of serum cytokines in patients with mycoplasma pneumoniae （MP）-induced cough variant asthma.Methods From April 2013 to April 2016,122 children with MP-induced cough variant asthma in our hospital were selected as study subjects and were randomly divided into combined group and routine group,61 cases in each group.The combined group was treated with low-dose budesonide and azithromycin while the routine group was treated with azithromycin alone.The clinical efficacy,serum cytokines,lung function indexes and the incidence rate of adverse reactions were compared.Results After the treatment,the levels of serum immunoglobulin E （IgE） and tumor necrosis factor α （TNF-α） in the combined group [（152.38＆#177;23.94） ng/L,（15.18＆#177;6.37） ng/L] were significantly lower than those in the routine group [（201.26＆#177;32.75） ng/L,（20.58＆#177;9.64） ng/L] （both P〈0.05） while the levels of transforming growth factor β1 （TGF-β1） and forced vital capacity （FVC） [（69.28＆#177;23.13） ng/L,（3.65＆#177;0.88） L] were significantly higher than those in the routine group [（47.16＆#177;20.33） ng/L,（3.12＆#177;0.95） L] （both P〈0.05）.Conclusion Low-dose budesonide combined with azithromycin can reduce airway hyperresponsiveness,relive clinical symptoms and improve pulmonary function by regulating serum TGF-β1,IgE,TNF-α and other cytokines in children with MP-induced cough variant asthma.