HAV疫苗干预对哮喘患儿治疗效果的影响

Impact of hepatitis A vaccine intervention on treatment effect in children with asthma

目的探讨甲型肝炎病毒(HAV)疫苗干预对儿童哮喘临床表现及脉冲震荡(IOS)肺功能的影响。方法选取陆军军医大学西南医院儿科就诊哮喘儿童80例为对照组,干预组儿童78例;采用HAV减毒活疫苗进行干预,观察接种后6个月及12个月临床表现及IOS肺功能,并进行病例对照研究分析。结果哮喘患儿HAV疫苗干预后6个月,干预组症状控制与部分控制率(89.8%)高于对照组(86.3%),但比较差异无统计学意义(P>0.05);干预12个月后,干预组症状控制与部分控制率(92.3%)与对照组(87.6%)相比明显升高,哮喘症状控制情况明显好转,比较差异有统计学意义(P<0.05)。哮喘患儿HAV疫苗干预后6个月,干预组周边气道黏性阻力(R5-R20)低于对照组,比较差异无统计学意义(P>0.05);干预12个月后,干预组呼吸总阻抗(Zrs)、共振频率(Fres)、总呼吸黏性阻力(R5)均低于对照组,比较差异有统计学意义(P<0.05)。结论HAV疫苗干预1年后可以改善儿童哮喘临床症状控制及IOS肺功能,HAV疫苗接种对小儿哮喘有保护作用。

Objective To investigate the impact of hepatitis A vaccine(HAV)intervention on clinical manifestations and impulse oscillometry(IOS)pulmonary function in children with asthma.Methods Eighty asthma children in the pediatric department of the Southwest Hospital of Third Military Medical University were selected as the control group,78 children were in the intervention group.The attenuated live HAV was adopted to conduct the intervention.The clinical manifestations and IOS pulmonary function were observed in 6 months and 12 months after inoculation.The case control study and analysis were performed.Results The symptom control and partial control rate at 6 months after HAV vaccine intervention in the intervention group was 89.8%,which was higher than 86.3%in the control group,but the difference was not statistically significant(P>0.05).The symptom control and partial control rate at 12 months after intervention in the intervention group was 92.3%,which in the control group was 87.6%,the asthma symptoms control situation in the intervention group was improved markedly,the difference was statistically significant(P<0.05).The peripheral airway viscosity resistance(R5-R20)at 6 months after HAV vaccine intervention in the intervention group was lower than that in the control group,but there was no statistically significant difference(P>0.05);Zrs,Fres,R5 at 12 months after intervention in the intervention group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion HAV vaccine intervention could improve clinical symptoms control and IOS lung function in children with asthma after one year.HAV vaccination has a protective effect on asthma in children.