规范应用布地奈德气雾剂的哮喘患儿血清神经营养素-3和嗜酸粒细胞水平的变化及意义

Changes and Significance of Serum Neurotrophin-3 and Eosinophil Levels in Asthmatic Children with Standard Application of Budesonide Aerosol

目的:分析布地奈德对哮喘患儿血清神经营养素-3(NT-3)和嗜酸粒细胞(EOS)水平的影响,以期为哮喘发病机制及临床治疗的深入研究提供新的候选标志物。方法:选择2017年3月至2018年3月于我院门诊就诊的轻中度慢性持续期哮喘患儿(哮喘组)和年龄性别相匹配的健康体检儿童(对照组)各90例。哮喘组患儿规范应用布地奈德气雾剂(200～400μg/d,每天2次)治疗8周。分别检测哮喘组患儿治疗前(入院24 h内)、治疗后(治疗第8周的最后一天)和对照组儿童的血清IgE、NT-3、EOS水平及哮喘控制测试评分(ACT评分)和肺功能[FEV1占预计值的百分比(FEV1%)]。结果:哮喘组患儿治疗后的ACT评分、FEV1%均较治疗前升高,但均低于对照组(P均<0.05);IgE、EOS、NT-3均较治疗前降低,但均高于对照组(P均<0.05)。结论:规范应用布地奈德气雾剂治疗轻中度慢性持续期哮喘患儿效果显著,其作用机制可能是通过调控血中NT-3、EOS水平减轻哮喘时伴发的炎症。

Objective:To analyze the effects of budesonide on serum neurotrophin-3(NT-3) and eosinophils(EOS) levels in children with asthma,in order to provide new candidate markers for the in-depth study of asthma pathogenesis and clinical treatment.Methods:Totally 90 cases of children with mild to moderate chronic persistent asthma(asthma group) and 90 cases of age-specific gender-matched healthy children(control group) were selected from Mar.2017 to Mar.2018.Children in the asthma group were treated with budesonide aerosol(200-400 μg/d twice daily) for 8 weeks.The serum IgE,NT-3,EOS levels,asthma control test score(ACT score) and lung function such as percentage of FEV1 in predicted values(FEV1%) were measured in children in the asthma group before treatment(within 24 h after admission),after treatment(the last day of the 8 thweek of treatment) and the control group respectively.Results:The ACT score and FEV1% of the asthma group were higher than those before treatment,yet the asthma group was lower than the control group(P<0.05).The IgE,EOS and NT-3 of the asthma group were lower than those before treatment,yet the asthma group was higher than the control group(P<0.05).Conclusion:The standard application of budesonide aerosol in the treatment of children with mild to moderate chronic persistent asthma is significant,and its mechanism of action may be to reduce the inflammation associated with asthma by regulating the levels of NT-3 and EOS in the blood.