不同剂量重组人干扰素α1b雾化吸入治疗儿童流行性感冒疗效观察

Efficacy of different doses of recombinant human interferon α1b inhalation for influenza in children

目的观察不同剂量重组人干扰素α1b雾化吸入治疗儿童流行性感冒(简称"流感")的临床效果。方法选取2017年12月至2019年1月在空军军医大学附属西京医院儿科门诊就诊的流感儿童147例,采用随机数表法均分为对照组、低剂量组和高剂量组各49例。对照组患者给予奥司他韦口服治疗,低剂量组患者在常规治疗的基础上给予重组人干扰素α1b 10μg雾化吸入,高剂量组患者在常规治疗的基础上给予重组人干扰素α1b 20μg雾化吸入。治疗5 d后,比较三组患者的治疗效果、各项临床症状的消失时间,以及治疗前后血清炎症细胞因子变化和不良反应发生情况。结果治疗5 d后,高剂量组和低剂量组患儿治疗总有效率分别为97.96%、91.84%,明显高于对照组的75.51%,差异均有统计学意义(P<0.05),而高剂量组与低剂量组患者的治疗总有效率比较差异无统计学意义(P>0.05);与治疗前比较,治疗后三组患者的肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)水平均明显下降,差异均有统计学意义(P<0.05),其中高剂量组、低剂量组患者的上述指标分别为(30.74±3.02) ng/L、(28.34±3.05)μg/L和(35.90±4.10) ng/L、(33.45±4.12)μg/L,明显低于对照组的(39.58±4.75) ng/L、(36.74.±4.70)μg/L,而高剂量组患者的TNF-α、IL-6水平明显低于低剂量组,差异均有统计学意义(P<0.05);高剂量组、低剂量组患者的高热、咽痛、咳嗽消失时间、住院时间[(4.50±0.99) d、(2.90±0.41) d、(3.64±0.58) d、(7.54±1.30) d;(5.20±1.18) d、(3.57±0.43) d、(4.10±0.62) d、(8.01±1.32) d]明显短于对照组[(5.90±1.64) d、(3.95±0.67) d、(4.87±0.90) d、(8.75±1.98) d],而高剂量组患者的高热、咽痛、咳嗽等临床症状消失时间及住院时间又明显低于低剂量组,差异均有统计学意义(P<0.05);治疗期间三组患者的不良反应发生率比较差异均无统计学意义(P>0.05)。结论高、低剂量重组人干扰素α1b雾化吸入均能明显降低患者的血清炎症因子水平,但高剂量重组人干扰素α1b雾化吸入的效果更为显著,能有效缓解患者的临床症状,缩短住院时间,值得推广使用。

Objective To observe the clinical effect of different doses of recombinant human interferon α1 b inhalation in children with influenza(referred to as "flu"). Methods A total of 147 children with influenza who were admitted to Department of Paediatrics, Xijing Hospital of Air Force Medical University from December 2017 to January2019 were selected. Using random number table method, they were divided into control group, low-dose group, and highdose group, each with 49 patients. The patients in the control group were given oral oseltamivir, the low-dose group received aerosol inhalation of recombinant human interferon alpha 1 b 10 μg on the basis of routine treatment, and the highdose group received aerosol inhalation of recombinant human interferon alpha 1 b 20 μg on the basis of routine treatment. After 5 days of treatment, the therapeutic effects, disappearance time of various clinical symptoms, changes in serum inflammatory cytokines, and adverse reactions before and after treatment were compared between the three groups.Results After 5 days of treatment, the total effective rate of treatment was 97.96% in the high-dose group and 91.84%in the low-dose group, both significantly higher than 75.51% in the control group(P<0.05);and the effective rate showed no statistically significant difference between the high-dose group wand the low-dose group(P>0.05). Compared with before treatment, the levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the three groups decreased significantly after treatment(P<0.05);the above indexes after treatment(30.74±3.02) ng/L,(28.34±3.05) μg/L in high-dose group,(35.90±4.10) ng/L,(33.45±4.12) μg/L in low-dose group, significantly lower than(39.58±4.75) ng/L,(36.74±4.70) μg/L in the control group(P<0.05);The levels of TNF-α and IL-6 in the high-dose group were significantly lower than those in the low-dose group(P<0.05). The time of disappearance of high fever, pharyngeal pain, cough,and lenghth of hospital stay were(4.50±0.99) d,(2.90±0.41) d,(3.64±0.58) d,(7.54±1.30) d in the high-dose group, significantly shorther than(5.20 ± 1.18) d,(3.57 ± 0.43) d,(4.10 ± 0.62) d,(8.22 ± 1.31) d in the low-dose group(P<0.05),which were all significantly shorter than(5.90±1.64) d,(3.95±0.67) d,(4.87±0.90) d,(8.75±1.98) d in the control group(P<0.05). The incidence of adverse reactions showed no statistically significant difference among the three groups(P>0.05). Conclusion Aerosol inhalation of high-and low-dose recombinant human interferon α1 b can effectively treat influenza in children. However, the effect of high-dose recombinant human interferon α1 b nebulization was more significant, which can effectively alleviate the clinical symptoms of patients, shorten the length of hospital stay, and is worthy of clinical promotion.