干扰素α2b给药途径对小儿病毒性肺炎疗效、T淋巴细胞亚群与血清KL-6、ICAM-1、TNF-α的影响

Influence of administration route of interferonα2b on the efficacy,T lymphocyte subsets and serum KL-6,ICAM-1,TNF-αin children with viral pneumonia

目的探讨干扰素α2b给药途径治疗小儿病毒性肺炎的疗效及其对T淋巴细胞亚群与血清KL-6、ICAM-1、TNF-α的影响。方法选取我院2017年3月至2019年3月收治的92例病毒性肺炎患儿,随机分为雾化组与肌注组,每组46例。比较两组治疗1周后的总有效率,记录两组治疗前及治疗1 d、2 d、3 d、4 d、5 d、6 d、7 d后的临床症状总评分,比较两组治疗前与治疗7 d后的血清CD^+_3、CD^+_4、CD^+_8、CD^+_4/CD^+_8、KL-6、ICAM-1、TNF-α水平与不良反应。结果两组的整体疗效与总有效率比较差异无统计学意义(P>0.05)。两组治疗后的临床症状总评分均呈下降趋势,组内前后差异有统计学意义(P<0.05)。雾化组治疗4 d、5 d、6 d、7 d的临床症状总评分低于肌注组(P<0.05)。治疗7 d后,两组CD^+_3、CD^+_4和CD^+_4/CD^+_8升高,CD^+_8降低(P<0.05);雾化组治疗7 d后CD^+_3、CD^+_4和CD^+_4/CD^+_8高于肌注组,CD^+_8低于肌注组(P<0.05)。治疗7 d后,两组各项血清学指标均明显降低(P<0.05),雾化组治疗后的血清ICAM-1、TNF-α低于肌注组(P<0.05),两组KL-6比较差异无统计学意义(P>0.05)。结论干扰素α2b雾化吸入给药可取得与肌注给药相当的疗效,同时可加速患儿症状缓解,调节免疫,血清ICAM-1、TNF-α下降幅度大,安全性良好。

Objective To investigate the influence of administration route of interferonα2 b on the efficacy,T lymphocyte subsets and serum KL-6,ICAM-1,TNF-αin children with viral pneumonia.Methods A total of 92 children with viral pneumonia admitted to our hospital from March 2017 to March 2019 were randomly divided into aerosolized group and intramuscular group,46 cases in each group.The total effective rate was compared between the two groups after 1 week of treatment.The total scores of clinical symptoms were recorded before treatment and at 1 d,2 d,3 d,4 d,5 d,6 d and 7 d after treatment.The levels of serum CD+3,CD+4,CD+8,CD+4/CD+8,KL-6,ICAM-1,TNF-αand adverse reactions before treatment and at 7 d after treatment were compared between the two groups.Results There was no significant difference in the overall efficacy and total effective rate between the two groups(P>0.05).The total scores of clinical symptoms after treatment in both groups showed a downward trend and there was statistical difference in each of the two groups(P<0.05).The total clinical symptom scores of aerosolized group were lower than those of intramuscular group at 4 d,5 d,6 d,and 7 d after treatment(P<0.05).After 7 d of treatment,CD+3,CD+4,CD+8 and CD+4/CD+8 in the two groups were increased,while CD+8 was decreased(P<0.05);CD+3,CD+4 and CD+4/CD+8 in aerosolized group were higher than those in intramuscular group,while CD+8 was lower than that in intramuscular group(P<0.05).After 7 d of treatment,the serum indexes of the two groups were decreased(P<0.05);the serum levels of ICAM-1 and TNF-αin aerosolized group were lower than those in intramuscular group(P<0.05),while the KL-6 between the two groups showed no significant difference(P>0.05).Conclusion Aerosolized interferonα2 b can achieve the same effect as intramuscular injection;meanwhile,it can accelerate the symptom relief,regulate immunity,decrease the levels of serum ICAM-1 and TNF-αwith higher security in children.