吸入型糖皮质激素对哮喘患儿NT-3和EOS水平的影响

Influence of inhaled corticosteroids on levels of neurotrophic-3 and eosinophils in children with asthma

目的探讨吸入型糖皮质激素对哮喘患儿的临床疗效及对血清神经营养素-3(NT-3)、外周血嗜酸性粒细胞(EOS)的影响及相关机制。方法选择2015年3月至2016年6月兰州大学第一医院收治的120例哮喘患儿作为研究对象,按随机数字表法将患儿分为研究组和对照组,各60例。对照组给予常规治疗,研究组在常规治疗基础上给予吸入型糖皮质激素治疗。连续治疗4周,观察两组患儿的临床疗效和血清NT-3、外周血EOS计数的变化。结果研究组总有效率显著高于对照组,差异有统计学意义(93.33%vs 71.67%,χ2=9.755,P<0.01);研究组与对照组治疗前血清NT-3水平[(55.98±13.45)ng/ml vs(55.98±13.45)ng/ml]和外周血EOS计数[(0.45±0.12)×109/L vs(0.42±0.13)×109/L]差异无统计学意义(P均>0.05);治疗2周后,研究组与对照组血清NT-3[(24.34±8.05)ng/ml、(34.56±9.87)ng/ml]和外周血EOS计数[(0.13±0.02)×109/L、(0.33±0.04)×109/L]较治疗前显著降低,且研究组低于对照组(P均<0.01)。结论哮喘患儿治疗的过程中加用糖皮质激素能提高临床疗效,其机制可能是降清血清NT-3水平和外周血EOS计数,控制气道炎症反应。

Objective To investigate the therapeutic effect of inhaled glucocorticoids on neurotrophic-3（ NT-3） and eosinophils（ EOS） in children with asthma and the mechanism. Methods A total of 120 children with asthma from March2015 to June 2016 were selected as research objects and divided into control group and research group according to random number table method（ n = 60,each）. Conventional treatment was performed in control group,and inhaled corticosteroids therapy was added based on routine treatment in research group. The clinical curative effect,changes of NT-3 and peripheral EOS count were observed after treatment for 4 weeks in two groups. Results The total effective rate in research group was significantly higher than that in control group（ 93. 33% vs 71. 67%,χ^2= 6. 989,P〈0. 05）. Before treatment,there were no statistical differences in NT-3 level[（ 55. 98 ± 13. 45） ng/ml vs（ 55. 98 ± 13. 45） ng/ml]and peripheral EOS count[（ 0. 45± 0. 12） ×10^9/L vs（ 0. 42 ± 0. 13） ×10^9/L]between two groups（ all P〈0. 05）. At 2 weeks after treatment,serum NT-3 level[（ 24. 34 ± 8. 05） ng/ml,（ 34. 56 ± 9. 87） ng/ml] and peripheral EOS count[（ 0. 13 ± 0. 02） ×10^9/L,（ 0. 33 ± 0. 04）×10^9/L]significantly decreased compared with pre-treatment in both two groups and were significantly lower in research group than those in control group（ all P〈0. 05）. Conclusions Glucocorticoids can improve the clinical efficacy in the treatment of asthmatic children. The mechanism may be related with the decrease of serum NT-3 and peripheral EOS counts that can control airway inflammation.