布地奈德雾化吸入对毛细支气管炎患儿血清IL-4、IFN-γ、TNF-α及T淋巴细胞亚群的影响

Effects of Aerosol Inhalation of Budesonide on the Serum IL-4,IFN-γ,TNF-α and T Lymphocyte Subsets of Children with Bronchiolitis

目的:研究布地奈德雾化吸入治疗小儿毛细支气管炎的临床疗效及对血清白介素-4(IL-4)和γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)及T淋巴细胞亚群的影响。方法:研究对象选取我院2014年1月到2017年1月收治的毛细支气管炎患儿70例,采用随机数字法将其分为对照组和观察组,每组35例。对照组患者给予吸氧、控制喘憋和抗病原体等常规治疗,观察组患者在对照组的基础上雾化吸入布地奈德联合特布他林及异丙托溴铵治疗。比较两组患者的治疗总有效率,各症状和体征缓解时间和住院时间,治疗前后的血清IL-4、IFN-γ、TNF-α和T淋巴细胞亚群CD3^+、CD4^+、CD8^+、及CD4^+/CD8^+水平的变化。结果:治疗后,观察组的治疗总有效率(97.14%)明显高于对照组(71.43%)(P=0.00);观察组气促缓解时间、哮鸣音消失时间、湿啰音消失时间、咳嗽消失时间、心率正常时间、住院时间明显短于对照组(P<0.01);观察组患者的CD3^+、CD4^+、及CD4^+/CD8^+细胞比值、血清IFN-γ水平均明显低于高于对照组,CD8^+、血清IL-4、TNF-α水平明显低于对照组(P<0.05)。结论:布地奈德雾化吸入治疗毛细支气管炎的临床疗效显著,可有效抑制炎症,增强机体免疫功能,且治疗安全性较高。

Objective： To study the clinical effect of budesonide inhalation on the children with bronchiolitis and its effect on the serum Interleukin -4 （IL-4） and interferon gamma （IFN- gamma）, tumor necrosis factor alpha （TNF- alpha） and T lymphocyte subsets. Methods： 70 patients with bronchiolitis treated in our hospital from January 2014 to January 2017 were selected and divided into the control group and observation group by random number method, In the control group, patients were given oxygen, controlled wheezing and anti-pathogens and other conventional treatment, on this basis, the observation group were treated with nebulized budesonide combined with terbutaline and ipratropium bromide. The total effective rate of treatment was compared between the two groups of patients. The remission time of symptoms and signs and hospitalization time were compared. The levels of serum inflanmaatory factors and T lymphocyte subsets were also compared before and after treatment. Results： The total effective rate （97.14%） was significantly higher in the observation group than that of the control group （71.43%）（P=0.00）; the remission duration of anhelation, the disappearance time of wheezing, rale, moist rale, cough, normal time of heart rate, hospitalization time of observation group were dominantly shorter than those of the control group （P〈0.01）. After treatment, the ratio of CD3＋, CD4＋, CD4＋/CD8＋ cells in the observation group were significantly lower than those of the control group, CD8＋ was significantly lower than that of the control group （P〈0.01）. The level of serum IL-4 and TNF- α in both groups were significantly lower than those of the control group, and the level of serum IFN-γ was significantly higher than that of the control group （P 〈0.05）. Conclusion： Inhalation of budesonide was effective in the treatment of bronchiolitis, it effectively inhibit the inflammation, enhance the immune function, lower the adverse reactions with high safety.