雾化吸入干扰素对重症手足口病患儿细胞因子的影响

Effects of aerosolized interferon on cytokines in cases with severe hand,foot and mouth disease

目的探讨雾化吸入重组人干扰素α1b(IFN-α1b)对重症手足口病(HFMD)患儿血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、C-反应蛋白(CRP)水平的影响。方法选取2015年6月至2016年10月西安市儿童医院收治的重症手足口病患儿100例,随机分为IFN-α1b plus HFMD实验组(50例)及HFMD对照组(50例),HFMD对照组给予常规治疗,IFN-α1b plus HFMD实验组在常规治疗基础上连续雾化吸入IFN-α1b治疗5d,采用酶联免疫吸附试验(ELISA)法检测治疗后两组患儿血清IL-6、TNF-α、IFN-γ及CRP水平。结果治疗第1天,两组患儿血清IL-6、TNF-α、IFN-γ和CRP浓度水平相近,差异均无统计学意义(t值分别为2.542、3.916、1.237、4.132,均P>0.05),治疗第3天、第5天,IFN-α1b plus HFMD实验组患儿血清IL-6、TNF-α、IFN-γ和CRP浓度水平明显下降,低于HFMD对照组,差异均有统计学意义(第3天:t值分别为11.023、11.867、10.745、15.264;第5天:t值分别为14.568、13.248、11.458、14.852;均P<0.05)。结论重组人IFN-α1b能够通过抗病毒作用和抑制细胞因子作用减轻炎症反应,从而减缓重症HFMD的发展。

Objective To study the effects of aerosolized recombinant interferonα1 b（IFN-α1 b）on serum interleukin 6（IL-6）,tumor necrosis factorα（TNF-α）,interferonγ（INF-γ）and C-reactive protein（CRP）levels in cases with severe hand-foot and mouth disease（HFMD）.Methods One hundred cases of severe HFMD were selected from June 2015 to October 2016 in Xi＇an Children＇s Hospital,and they were randomly divided into IFN-α1 bplus HFMD experimental group and HFMD control group.Conventional treatment was provided for the control group,and continuous aerosolized IFN-α1 bfor 5 days was additionally provided for the experimental group.Serum IL-6,TNF-α,INF-γand CRP levels were detected by ELISA.Results The levels of serum IL-6,TNF-α,INF-γand CRP levels were similar in two groups after 1-day treatment,and the difference was not significant（t value was2.542,3.916,1.237,4.132,P 0.05）.At 3 and 5 day after treatment,serum IL-6,TNF-α,INF-γand CRP levels declined remarkably in the experimental group,and they were lower than those in the control group with statistical significance（t value was11.023,11.867,10.745 and 15.264 at 3 day,t value was 14.568,13.248,11.458 and 14.852 at 5 day）.Conclusion The inflammatory reaction is relieved through antiviral effect and inhibitory effect with IFN-α1 b,delaying the development of severe HFMD.