不同剂量重组人干扰素α2b雾化吸入治疗儿童病毒性肺炎的疗效及其对血清炎性因子和免疫功能的影响

Different Doses of Recombinant Human Interferon α2b Inhalation in the Treatment of Children with Viral Pneumonia and Its Effect on Serum Inflammatory Factors and Immune Function

目的:探讨雾化吸入不同剂量重组人干扰素α2b注射液对病毒性肺炎患儿血清炎性因子水平及免疫功能的影响。方法:选择2015年1月至2017年6月我院收治的病毒性肺炎患儿140例,按照给药剂量分为高剂量组(n=46)、低剂量组(n=48)和对照组(n=46)。三组患儿均接受病毒性肺炎常规治疗,高剂量组给予重组人干扰素α2b注射液每次20万U/kg雾化吸入治疗,低剂量组给予重组人干扰素α2b注射液每次10万U/kg雾化吸入治疗,对照组给予0.9%生理盐水2 m L雾化吸入治疗。观察三组患儿临床疗效、不良反应以及治疗前、治疗3周后血清炎症因子水平和免疫功能的变化。结果:高剂量组和低剂量组总有效率高于对照组(P<0.05),高剂量组和低剂量组总有效率比较差异无统计学意义(P>0.05)。三组患儿不良反应发生率比较差异无统计学意义(P>0.05)。治疗3周后三组患儿血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均较治疗前降低(P<0.05),高剂量组IL-6、TNF-α、CRP水平低于低剂量组和对照组(P<0.05),低剂量组IL-6、TNF-α、CRP水平低于对照组(P<0.05)。治疗3周后高剂量组和低剂量组血清CD3^+、CD4^+、CD4^+/CD8^+较治疗前升高,CD8^+较治疗前降低(P<0.05);对照组CD3^+、CD4^+/CD8^+较治疗前显著升高,CD8^+较治疗前显著降低(P<0.05),CD4^+比较差异无统计学意义(P>0.05)。高剂量组CD3^+、CD4^+、CD4^+/CD8^+高于低剂量组和对照组,CD8^+低于低剂量组和对照组(P<0.05),低剂量组CD3^+、CD4^+、CD4^+/CD8^+高于对照组,CD8^+低于对照组(P<0.05)。结论:雾化吸入重组人干扰素α2b注射液可以降低病毒性肺炎患儿血清炎性因子水平,增强患儿细胞免疫功能,每次20万U/kg雾化吸入的效果优于10万U/kg,值得临床推广应用。

Objective： To investigate the effects of different doses of recombinant human interferon α2b injection inhalation on serum inflammatory factors and immune function in children with viral pneumonia. Methods： One hundred and forty children with viral pneumonia admitted into our hospital from Jan. 2015 to Jun. 2017 were extracted to be divided into high-dose group（ n = 46）,low-dose group（ n = 48） and control group（ n = 46） according to different dosage. All patients were given routine treatment with viral pneumonia,the high-dose group received recombinant human interferon α2b injection of 200,000 U/（ kg·times） by atomization inhalation,and the low-dose group was treated with recombinant human interferon α2 b injection of 100,000 U/（ kg·times） by atomization inhalation and the control group received 0.9% saline to 2 m L atomization inhalation treatment. The clinical efficacy,adverse drug reactions（ ADR）,changes of serum inflammatory factors and immune function were observed before and after treatment. Results： The total effective rate was higher in the high-dose group and low-dose group than in the control group（ P0.05）,there was no significant difference in the total effective rate between the high-dose group and low-dose group（ P 0.05）. There was no significant difference in the incidence of ADR among three groups（ P0.05）. After 3 weeks of treatment,the levels of serum interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α）and C-reactive protein（ CRP） in three groups were lower than those before treatment（ P0.05）,the levels of IL-6,TNF-α and CRP in the high-dose group were lower than those in the low-dose group and control group（ P0.05）,the levels of IL-6,TNF-α and CRP in the low-dose group were lower than those in the control group（ P0.05）. After 3 weeks of treatment,the serum CD3~＋,CD4~＋,CD4~＋/CD8~＋in the high-dose group and low-dose group were higher than before treatment,and CD8~＋was lower than before treatment（ P0.05）,the CD3~＋and CD4~＋/CD8~＋in the control group were significantly higher than before treatment,CD8~＋was significantly lower than before treatment（ P0.05）,and there was no significant difference in CD4~＋（P0.05）. The CD3~＋,CD4~＋,CD4~＋/CD8~＋of the high-dose group was higher than those of the low-dose group and control group,while the CD8~＋was lower than that of the low-dose group and control group（ P0.05）,the CD3~＋,CD4~＋,CD4~＋/CD8~＋of the low-dose group were higher than those of the control group,and the CD8~＋was lower than that of the control group（ P 0. 05）. Conclusion： Different doses of recombinant human interferon α2 b inhalation in the treatment of children with viral pneumonia can reduce the serum inflammatory factors and enhance the cellular immune function in children with viral pneumonia,the effect of inhalation of 200,000 U/kg per inhalation is better than that of 100,000 U/（ kg·times）,the treatment method is worthy of clinical application.