布地奈德联合维生素D3治疗小儿哮喘的疗效观察及对外周血IgE、TSLP和TLRs水平的影响

Clinical Efficacy of Budesonide Combined with Vitamin D3 in the Treatment of Children with Asthma and the Influence on the Levels of IgE, TSLP and TLRs in Peripheral Blood

目的探讨布地奈德联合维生素D3治疗小儿哮喘的临床疗效及对患儿外周血免疫球蛋白E(IgE)、胸腺基质淋巴细胞生成素(TSLP)、Toll样受体(TLRs)水平的影响。方法选取114例哮喘患儿作为研究对象,采用随机数字表法将其分为对照组和观察组,每组57例,对照组给予布地奈德雾化吸入治疗,观察组在此基础上加用维生素D3,观察两组临床疗效,记录主要症状消失时间,测定治疗前后外周血血清免疫球蛋白(IgA、IgG、IgM、IgE)、TSLP水平及单核细胞TLRs表达情况。结果观察组临床疗效总有效率明显高于对照组(P<0.05);治疗后观察组咳嗽、喘息、呼吸困难、肺部啰音等主要症状消失时间均明显短于对照组(P<0.05);两组IgA、IgE水平均明显降低(P<0.05),IgG、IgM水平均明显升高(P<0.05),且观察组各指标水平变化程度均明显高于对照组(P<0.05);两组血清TSLP水平明显降低(P<0.05),单核细胞TLR2的表达明显增强(P<0.05),TLR4的表达明显下调(P<0.05),且观察组TSLP水平明显低于对照组(P<0.05),单核细胞TLR2、TLR4的表达强度变化程度均明显高于对照组(P<0.05)。结论布地奈德联合维生素D3治疗小儿哮喘疗效显著,能够有效降低血清IgE、TSLP水平,调控TLR2、TLR4的表达,值得推广应用。

Objective To explore the clinical efficacy of Budesonide combined with Vitamin D3 in the treatment of children with asthma and the influence on the levels of immunoglobulin E (IgE), thymic stromal lymphopoietin (TSLP) and Toll like receptors (TLRs) in peripheral blood. Methods 114 children with asthma were selected as the research subjects and were divided into the control group and the observation group by the random number table method, with 57 cases in each group, the control group was treated with Budesonide nebulization and inhalation, and the observation group added vitamin D3 on this basis, observed the clinical efficacy of the two groups, recorded the disappearance time of main symptoms, the serum immunoglobulin (IgA, IgG, IgM, IgE), TSLP levels of peripheral bloodandTLRs expression in mononuclear cells before and after the treatment were measured, and the incidence rate of adverse reactions was statistically analyzed. Results The total effective rate in the observation group was significantly higher than that in the control group (P<0.05);after treatment, the disappearance time of main symptoms such as cough, wheezing, dyspnea, lung rale and others in the observation group was significantly shorter than that in the control group (P<0.05);the levels of IgA and IgE in the two groups were significantly decreased (P<0.05), the levels of IgG and IgM increased significantly (P<0.05), the levels of each index in the observation group were significantly higher than those in the control group (P<0.05);the level of serum TSLP in the two groups was significantly lower (P<0.05), the expression of TLR2 in mononuclear cells was significantly enhanced (P<0.05), the expression of TLR4 was significantly down (P<0.05), and the level of TSLP in the observation group was significantly lower than that in the control group (P<0.05), the changes degree of TLR2 and TLR4 expression intensities in mononuclear cells were significantly higher than those in the control group (P<0.05). Conclusion Budesonide combined with vitamin D3 is effective in treating asthma in children, it can effectively reduce serum IgE and TSLP levels, regulate the expressions of TLR2 and TLR4, and has low risk of adverse reactions, so it is worthy of popularization and application.