阿奇霉素联合甲泼尼龙治疗小儿难治性支气管哮喘的临床疗效及其对免疫功能的影响

Clinical effect and the impact on immune function of azithromycin combined with methylprednisolone in the treatment of refractory bronchial asthma in children

目的探讨阿奇霉素联合甲泼尼龙治疗小儿难治性支气管哮喘的临床疗效及其对免疫功能的影响。方法选取长沙市第四医院2017年8月-2018年8月收治的难治性支气管哮喘患儿80例,按照随机数字表法分为对照组与观察组,各40例。对照组予以阿奇霉素治疗,观察组在对照组基础上联合甲泼尼龙治疗,两组均连续用药2周。比较两组临床疗效,治疗前后IgE、T淋巴细胞亚群(CD4^+细胞分数、CD8+细胞分数、CD4^+/CD8^+细胞比值)。结果观察组临床疗效优于对照组(P<0.05)。治疗前两组IgE、CD4^+细胞分数、CD8^+细胞分数、CD4^+/CD8^+细胞比值比较,差异无统计学意义(P>0.05);治疗后观察组IgE、CD8+细胞分数低于对照组,CD4^+细胞分数、CD4^+/CD8^+细胞比值高于对照组(P<0.05)。结论阿奇霉素联合甲泼尼龙治疗小儿难治性支气管哮喘的临床疗效确切,可提高患儿免疫功能。

Objective To investigate the clinical effect and the impact on immune function of azithromycin combined with methylprednisolone in the treatment of refractory bronchial asthma in children.Methods A total of 80 cases of children with refractory bronchial asthma were selected from August 2017 to August 2018 in the Fourth Hospital of Changsha,which were divided into control group and observation group according to the method of random number table,40 cases in each group.The control group was treated with azithromycin,and the observation group was treated with methylprednisolone on the basis of the control group,both groups were treated for 2 weeks.The clinical effect,IgE,lymphocyte subsets(CD4^+cell fraction,CD8+cell fraction,CD4^+/CD8^+cell ratio)before and after treatment were compared between the two groups.Results The clinical effect of the observation group was better than control group(P<0.05).Before treatment,there was no significant difference in IgE,CD4^+cell fraction,CD8^+cell fraction and CD4^+/CD8^+cell ratio between the two groups(P>0.05);after treatment,the observation group of IgE and CD8^+cell fraction were lower than control group,and the CD4^+cell fraction,CD4^+/CD8^+cell ratio were higher than control group(P<0.05).Conclusion Azithromycin combined with methylprednisolone have an exact clinical effect for refractory bronchial asthma in children,which can improve the immune function of children.