糖皮质激素联合应用脾氨肽对CARAS患儿免疫及肺功能的影响研究

Effects of glucocorticoid combined with spleen aminopeptide on immune function and pulmonary function in children with CARAS

目的考察糖皮质激素联合应用脾氨肽对过敏性鼻炎-哮喘综合征(CARAS)患儿免疫及肺功能的影响。方法将166例CARAS患儿分为观察组(84例)与对照组(82例),对照组患儿采用经鼻吸入布地奈德气雾剂进行治疗,观察组在对照组的基础上加用脾氨肽口服冻干粉进行治疗,2组患儿均连续治疗3个月。比较2组患儿的疗效,以及治疗前后免疫及肺功能的变化。结果 2组患儿的鼻炎及哮喘病情在治疗后均明显减轻,且观察组的鼻炎症状评分与哮喘评分降低程度均较对照组更显著(P<0.05)。2组患儿的体液免疫指标(IgG、IgM、IgA)在治疗后均明显升高,细胞免疫指标中CD3^+、CD4^+及CD4^+/CD8^+比值均明显升高,CD8^+明显降低,观察组各项免疫指标均较对照组显著改善(P<0.05)。治疗后2组患儿的第1秒用力呼气容积(FEV1)与最大呼气流速(PEFR)均较治疗前显著升高,且观察组升高程度显著大于对照组(P<0.01)。结论糖皮质激素联合应用脾氨肽不仅能有效改善CARAS患儿的症状与体征,同时还能显著增强其免疫功能及肺功能。

Objective To investigate the effects of glucocorticoid combined with spleen aminopeptide on immune function and pulmonary function in children with combined allergic rhinitis and asthma syndrome（CARAS）.Methods A total of 166 cases of CARAS were divided into observation group（84 cases）and control group（82 cases）,the patients in the control group were treated by nasal inhalation of Budesonide Aerosol,in addition to the treatment of control group the observation group was given spleen aminopeptide oral lyophilized powder for treatment,and two groups were treated continuously for 3 months.The effect of 2 groups of children,and the changes of immune and lung function before and after treatment were compared.ResultsRhinitis and asthma were significantly reduced in two groups of children after treatment,and the reductions of the score of rhinitis symptoms and the asthma score in the observation group were more significant than those in the control group（P〈0.05）.The humoral immunity index（IgG,IgM and IgA）of the 2 groups increased significantly after treatment.CD3~＋,CD4~＋and the ratio of CD4~＋/CD8~＋in the cellular immune indexes increased significantly,and CD8~＋decreased significantly.The immune indexes in the observation group were significantly improved compared with those in the control group（P〈0.05）.After treatment,the forced expiratory volume in one second（FEV1）and maximal expiratory flow rate（PEFR）of the 2 groups increased significantly compared with those before treatment,and the degree of increase in the observation group was significantly higher than that in the control group（P〈0.01）.Conclusion Glucocorticoid combined with spleen aminopeptide could not only improve the symptoms and signs of children with CARAS,but also significantly enhance cellular immunity,humoral immunity and pulmonary function.