不同剂量重组人干扰素α_2b注射液雾化吸入治疗小儿病毒性肺炎临床疗效的对比研究

Comparative Study for Clinical Effect in Treating Children with Viral Pneumonia of Aerosol Inhalation of Different Doses of Recombinant Human Interferon α_2b Injection

目的比较不同剂量重组人干扰素α2b注射液雾化吸入治疗小儿病毒性肺炎的临床疗效。方法选取2013年9月—2014年8月保定市第一中心医院儿科收治的病毒性肺炎患儿120例,其中中途退出19例,最终纳入患儿101例,采用随机数字表法分为对照组35例、低剂量组36例、高剂量组30例。3组患儿均给予常规治疗,低剂量组患儿给予低剂量重组人干扰素α2b注射液(10万U·kg^(-1)·次^(-1))雾化吸入,高剂量组患儿给予高剂量重组人干扰素α_2b注射液(20万U·kg^(-1)·次^(-1))雾化吸入;3组患儿均连续治疗1周。比较3组患儿临床疗效及咳嗽、喘憋、肺部啰音消失时间,治疗前后血清炎性因子[肿瘤坏死因子α(TNF-α)、白介素6(IL-6)]水平,并记录低剂量组、高剂量患儿治疗期间不良反应发生情况。结果低剂量组、高剂量组患儿临床疗效优于对照组(P<0.05),高剂量组患儿临床疗效优于低剂量组(P<0.05)。低剂量组、高剂量组患儿咳嗽、喘憋、肺部啰音消失时间短于对照组(P<0.05),高剂量组患儿咳嗽、喘憋及肺部啰音消失时间短于低剂量组(P<0.05)。治疗前3组患儿TNF-α、IL-6水平比较,差异无统计学意义(P>0.05);治疗后低剂量组、高剂量组患儿血清TNF-α、IL-6水平低于对照组(P<0.05),高剂量组患儿血清TNF-α、IL-6水平低于低剂量组(P<0.05)。低剂量组患儿治疗期间不良反应发生率低于高剂量组(P<0.05)。结论与低剂量重组人干扰素α_2b注射液(10万U·kg^(-1)·次^(-1))相比,高剂量重组人干扰素α_2b注射液(20万U·kg^(-1)·次^(-1))雾化吸入治疗小儿病毒性肺炎的临床疗效更佳,能更有效地降低患儿血清炎性因子水平,但高剂量重组人干扰素α_2b注射液所致不良反应风险发生升高,临床应根据患儿个体情况及耐受性等选择应用。

Objective To compare the clinical effect in treating children with viral pneumonia of aerosol inhalation of different doses of recombinant human interferon α2binjection. Methods From September 2013 to August 2014,a total of 120 children with viral pneumonia were selected in the Department of Pediatrics,the First Central Hospital of Baoding,thereinto 19 cases quit midway,thus 101 cases enrolled into this study finally,and they were divided into control group（ n = 35）,low-dose group（ n = 36） and high-dose group（ n = 30） according to random number table. Children of the three groups received conventional treatment,meanwhile children of low-dose group received aerosol inhalation of low-dose recombinant human interferon α2binjection（ 100,000 U/kg per time）,while children of high-dose group received aerosol inhalation of high-dose recombinant human interferon α2binjection（ 200,000 U/kg per time）; all of the three groups continuously treated for 1week. Clinical effect,disappearance time of cough,wheezes and lung rale,serum inflammatory cytokines（ including TNF-α and IL-6） levels before and after treatment were compared among the three groups,and incidence of adverse reactions of low-dose group and high-dose group was recorded during the treatment. Results Clinical effect of low-dose group and high-dose group was statistically significantly better than that of control group（ P〈0. 05）,respectively,meanwhile clinical effect of high-dose group was statistically significantly better than that of low-dose group（ P〈0. 05）. Disappearance time of cough,wheezes and lung rale of low-dose group and high-dose group was statistically significantly shorter than that of control group（ P〈0. 05）,respectively,meanwhile disappearance time of cough（ P〈0. 05）,wheezes and lung rale of high-dose group was statistically significantly shorter than that of low-dose group,respectively（ P〈0. 05）. No statistically significant differences of serum level of TNF-α or IL-6 was found among the three groups before treatment（ P〉0. 05）; after treatment,serum levels of TNF-α and IL-6 of low-dose group and high-dose group were statistically significantly lower than those of control group（ P〈0. 05）,meanwhile serum levels of TNF-α and IL-6 of high-dose group were statistically significantly lower than those of low-dose group（ P〈0. 05）. Incidence of adverse reactions of low-dose group was statistically significantly lower than that of high-dose group（ P〈0. 05）. Conclusion Compared with low-dose aerosol inhalation of low-dose recombinant human interferonα2binjection,aerosol inhalation of high-dose recombinant human interferon α2binjection has better clinical effect in treating children with viral pneumonia, can more effectively reduce the serum inflammatory cytokines levels, but the risk of adverse reactions significantly increases, clinicians should choose reasonable dose of recombinant human interferon α2b injection according to the Individual situation and tolerance.