布地奈德对感染诱发哮喘急性发作患儿干扰素-γ及血清炎性因子水平的影响

Effect of budesonide on the levels of interferon-gamma and serum inflammatory factors in children with acute attack of asthma induced by infection

目的探讨布地奈德对感染诱发哮喘急性发作患儿干扰素-γ及血清炎性因子水平的影响。方法选取神木市医院2015年12月至2018年12月收治的既往哮喘入院时未出现喘息的呼吸道支原体(MP)感染患儿108例,根据随机数表法分成观察组和对照组,每组54例,对照组患儿接受常规治疗,观察组患儿在常规治疗的基础上予以布地奈德雾化吸入,疗程为3~5 d。比较两组患儿治疗后的临床效果、第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)、FEV1/用力呼吸的肺活量(FVC)和临床症状;测定并比较治疗前后两组患儿的干扰素-γ(IFN-γ)及血清炎性因子水平[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)]。结果观察组患儿的治疗总有效率为83.33%,明显高于对照组的66.67%,差异具有统计学意义(P<0.05);治疗后观察组患儿咳嗽、肺部啰音、呼吸困难消失时间分别为(5.79±1.09)d、(6.63±1.01)d、(2.66±1.03)d,均明显短于对照组的(7.67±2.25)d、(7.71±1.24)d、(4.30±1.12)d,差异均有统计学意义(P<0.05);两组患儿治疗前的肺功能指标及血清细胞因子比较差异均无统计学意义(P>0.05);治疗后观察组患儿的FEV1、PEF、FEV1/FVC分别为(92.24±6.40)%、(95.46±12.02)%、(82.34±4.87),明显高于对照组的(68.84±6.21)%、(71.39±10.23)%、(72.31±4.98),差异均有统计学意义(P<0.01);治疗后观察组患儿的IFN-γ为(24.44±3.42)pg/mL,明显高于对照组的(18.14±5.22)pg/mL,IL-6、IL-8、TNF-α水平分别为(175.78±44.65)ng/L、(77.46±18.56)ng/L、(220.25±32.14)ng/L,明显低于对照组的(219.39±38.25)ng/L、(104.36±21.45)ng/L、(384.25±35.69)ng/L,差异均具有统计学意义(P<0.05)。结论布地奈德能有效改善MP感染患儿的临床症状及肺部体征,提高肺活量水平,增加血清IFN-γ水平,降低炎症因子水平,可减少感染诱发哮喘急性发作。

Objective To investigate the effect of budesonide on the levels of interferon-gamma(IFN-γ)and serum inflammatory factors in children with acute asthma attack induced by infection.Methods A total of 108 children with mycoplasma pneumoniae(MP)infection who had no wheeze during admission to Shenmu Hospital from December 2015 to December 2018 were randomly divided into an observation group and a control group,with 54 patients in each group.The control group received routine treatment,while the observation group received budesonide aerosol inhalation on the basis of routine treatment.The course of treatment lasted 3 to 5 days.The clinical effects,forced expiratory volume(FEV1),peak expiratory flow(PEF),FEV1/forced expiratory vital capacity(FVC),and clinical symptoms were observed and compared between the two groups.The levels of IFN-γ,serum inflammatory factors,interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor(TNF-α)were measured and compared between the two groups before and after treatment.Results After treatment,the effective rate of the observation group was 83.33%,significantly higher than 66.67%in the control group(P<0.05).After treatment,the disappearance time of cough,rale,and dyspnea in the observation group were(5.79±1.09)d,(6.63±1.01)d,(2.66±1.03)d,respectively,which were significantly shorter than(7.67±2.25)d,(7.71±1.24)d,(4.30±1.12)d in the control group(P<0.05).There was no significant difference in pulmonary function and serum cytokines between the two groups before treatment(P>0.05).After treatment,FEV1,PEF,and FEV1/FVC in the observation group were(92.24±6.40)%,(95.46±12.02)%,82.34±4.87,respectively,which were significantly higher than(68.84±6.21)%,(71.39±10.23)%,72.31±4.98 in the control group(P<0.05).After treatment,the levels of IFN-γin the observation group were(24.44±3.42)pg/mL,significantly higher than(18.14±5.22)pg/mL in the control group(P<0.05).The levels of IL-6,IL-8,and TNF-α were(175.78±44.65)ng/L,(77.46±18.56)ng/L,(220.25±32.14)ng/L,respectively,which were significantly lower than(219.39±38.25)ng/L,(104.36±21.45)ng/L,(384.25±35.69)ng/L in the control group(P<0.05).Conclusion Budesonide can effectively improve the clinical symptoms and pulmonary signs of children with asthma,improve vital capacity,increase serum IFN-γlevels,reduce the level of inflammatory factors,and reduce the acute attack of asthma induced by infection.