布地奈德联合沙丁胺醇对支气管哮喘患儿氧化应激及炎性因子的影响

Influence of inhaled budesonide and salbutamol on oxidative stress and serum inflammatory cytokines in children with bronchial asthma

目的 观察布地奈德联合沙丁胺醇雾化吸入治疗支气管哮喘的临床效果及其对患儿血清氧化应激反应、白细胞介素2（IL-2）、可溶性受体2（sIL-2r）水平的影响.方法 选择支气管哮喘患儿70例为研究对象,根据治疗方案不同分为观察组、对照组各35例,观察组采用布地奈德联合沙丁胺醇雾化吸入治疗,对照组采用沙丁胺醇雾化吸入治疗.观察两组临床疗效,比较两组治疗前后血清氧化应激因子、IL-2及s-IL-2r水平的变化.结果 观察组痊愈20例,显效7例,有效5例,总有效率94.3％;对照组痊愈17例,显效6例,有效4例,总有效率77.1％;两组总有效率差异有统计学意义（χ2=26.543,P＜O.05）.治疗后,观察组丙二醇（MDA）、终末期产物（AOPP）分别为（16.26±1.76） U/L、（42.12±5.74） μmol/L,低于对照组的（22.16±2.84） U/L、（63.63±6.22） μmol/L（t=23.354、25.348,均P＜0.05）;观察组谷胱甘肽过氧化物酶（GSH-PX）、超氧化物歧化酶（SOD）分别为（236.46±32.25） ng/L、（19.64±3.58） ng/L,高于对照组的（197.43±18.42） ng/L、（18.24±2.44） ng/L（t=18.943、15.123,均P＜0.05）;观察组IL-2、sIL-2r水平分别为（5.28±2.65）μg/L、（30.37±2.14）mg/L,均明显低于对照组的（9.84±3.22） μg/L、（37.56士1.32）mg/L,差异均有统计学意义（t =21.378、24.643,均P＜0.05）.结论 布地奈德联合沙丁胺醇雾化吸入治疗小儿支气管哮喘有助于控制哮喘症状,抑制患儿氧化应激反应程度、降低血清sIL-2r和IL-2水平,值得临床推广.

Objective To observe the clinical effect of budesonide combined with salbutamol in the treatment of children with bronchial asthma,and its influence on oxidative stress and serum interleukin-2 （IL-2）,soluble IL-2 receptor （sIL-2r） levels.Methods 70 children with bronchial asthma were divided into observation group and control group according to the different treatment,35 cases in each group.The observation group was inhaled budesonide combined with salbutamol,the control group was given salbutamol inhalation therapy.The clinical efficacy of the two groups was observed,and the changes of serum oxidative stress factor,IL-2 and sIL-2r levels before and after treatment in the two groups were compared.Results In the observation group,20 cases were cured,7 cases were markedly effective,effective in 5 cases,the total effective rate was 94.3%.In the control group,17 cases were cured,6 cases were markedly effective,effective in 4 cases,the total effective rate was 77.1%.The total effective rate between the two groups had statistically significant difference （χ2 =26.543,P 〈 0.05）.After treatment,the malondialdehyde （MDA）,end products （AOPP） of the observation group were （16.26 ± 1.76）U/L,（42.123 ± 5.745） μmol/L,respectively,which were lower than those of the control group [（22.16 ± 2.84） U/L,（63.63 ± 6.22） μ mol/L,t =23.354,25.348,all P 〈 0.05].The glutathione peroxidase （GSH-PX）,superoxide dismutase （SOD） of the observation group were （236.46 ± 32.25） ng/L,（19.643 ± 3.587） ng/L,respectively,which were higher than those of the control group [（197.43 ± 18.42） ng/L,（18.244 ± 2.446） ng/L,t =18.943,15.123,all P 〈O.05].The IL-2,sIL-2r levels of the observation group were （5.28 ± 2.65） μg/L,（30.376 ± 2.147） mg/L,respectively,which were significantly lower than those of the control group [（9.84 ± 3.22） μg/L,（37.564 ± 1.323）mg/L],the differences were statistically significant （t =21.378,24.643,all P 〈 O.05）.Conclusion Inhaled budesonide combined with salbutamol in the treatment of children with bronchial asthma is helpful to control the symptoms of asthma,and can inhibit oxidative stress,reduce serum sIL-2r and IL-2 levels,it is worthy of promotion.