盐酸氨溴索联合阿奇霉素序贯疗法对支原体肺炎患儿细胞因子及共刺激分子的影响

Effect of ambroxol hydrochloride combined with azithromycin sequential therapy on serum cytokines and co-stimulatory molecules in children with Mycoplasma pneumonia

目的:探讨盐酸氨溴索联合阿奇霉素序贯疗法对支原体肺炎患儿细胞因子及共刺激分子的影响。方法:选取肺炎支原体肺炎患儿80例,随机分为观察组和对照组,各40例。对照组采用阿奇霉素序贯疗法,观察组在对照组基础上联合应用盐酸氨溴索。比较2组患儿治疗效果和治疗前后血清细胞因子及共刺激分子水平。结果:观察组患儿治疗总有效率为97.5%,高于对照组的82.5%(P<0.05)。观察组患儿热退时间、咳嗽消失时间和住院时间均明显短于对照组(P<0.01)。2组患儿治疗前血清白细胞介素(IL)-4、IL-17、IL-18和干扰素(IFN)-γ及可溶性B7同源体3(s B7-H3)水平差异均无统计学意义(P>0.05);治疗后2组IL-4、IL-17、IL-18、IFN-γ及s B7-H3水平均较治疗前明显下降(P<0.01),且观察组患儿治疗后IL-4、IL-17、IL-18、IFN-γ及s B7-H3水平均明显低于对照组(P<0.01)。结论:盐酸氨溴索联合阿奇霉素序贯疗法治疗儿童支原体肺炎疗效显著,并能有效改善患儿细胞因子和共刺激分子水平,有助于抑制炎症反应,利于患儿恢复。

Objective： To analyze the effects of ambroxol hydrochloride combined with azithromycin sequential therapy on serum cytokines and co-stimulatory molecules in children with Mycoplasma pneumonia. Methods： Eighty children with Mycoplasma pneumonia were randomly divided into the observation group and control group（ 40 cases each group）. The control group was treated with azithromycin sequential therapy,and the observation group was treated with ambroxol hydrochloride combined with azithromycin sequential therapy. The therapeutic effect between two groups was compared. The serum levels of cytokines and co-stimulatory molecules in two groups between before and after treatment were compared. Results： The total effective rate in observation group（ 97. 5%） was higher than that in control group（ 82. 5%）（ P〈 0. 05）. The average annealing thermal time,cough disappearing time and length of hospital stay in observation group were significantly shorter than those in control group（ P〈 0. 01）. The differences of the levels of IL-4、IFN-γ、IL-17、IL-18 and s B7-H3 between two groups before treatment were not statistically significant（ P〉 0. 05）. Compared with before treatment,the levels of IL-4、IFN-γ、IL-17、IL-18 and s B7-H3 in two groups significantly decreased after treatment（ P 〈0. 01）,and which in observation group was significantly lower than that in control group after treatment（ P 〈0. 01）. Conclusions： The treatment effect of ambroxol hydrochloride combined with azithromycin sequential therapy in children with Mycoplasma pneumonia is significant,which can effectively improve the serum levels of cytokines and co-stimulatory molecules,inhibit the inflammatory reaction,and help recovery of children.