脾氨肽联合吸入糖皮质激素治疗儿童过敏性鼻炎-哮喘综合征的效果及对外周血嗜酸性粒细胞水平的影响

Effect of spleen aminopeptide combined with inhaled corticosteroids in the treatment of children with allergic rhinitis-asthma syndrome and its influence on peripheral blood eosinophil count

目的分析脾氨肽联合吸入糖皮质激素治疗儿童过敏性鼻炎-哮喘综合征的效果及对外周血嗜酸性粒细胞水平的影响。方法78例过敏性鼻炎-哮喘综合征患儿,经简单随机分组法分为对照组和观察组,每组39例。对照组患儿接受吸入糖皮质激素治疗,观察组患儿给予脾氨肽联合吸入糖皮质激素治疗。比较两组患儿治疗前后的免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)和外周血T淋巴细胞亚群(CD4^(+)、CD8^(+)以及CD4^(+)/CD8^(+))]、肺功能[第1秒用力呼气容积占预计值的百分比(FEV1%)、呼气高峰流速(PEFR)]、嗜酸性粒细胞直接计数(EOS)水平、症状评分。结果治疗后,观察组患儿的IgG(10.47±1.06)g/L、IgM(7.47±0.84)g/L、IgA(7.47±0.92)g/L、CD4^(+)(40.60±3.02)%以及CD4^(+)/CD8^(+)(1.94±0.19)均明显高于对照组的(9.01±0.84)g/L、(6.41±0.65)g/L、(6.37±0.67)g/L、(35.51±2.93)%、(1.29±0.08),CD8^(+)(22.47±0.75)%明显低于对照组的(25.96±1.87)%,差异均具有统计学意义(P<0.05)。治疗后,观察组患儿的FEV1%(89.97±5.08)%、PEFR(4.95±0.54)L/s均明显高于对照组的(82.36±4.94)%、(4.18±0.31)L/s,EOS(0.11±0.01)×10^(9)/L低于对照组的(0.39±0.02)×10^(9)/L,差异均具有统计学意义(P<0.05)。观察组患儿的鼻炎症状(AR)评分(1.09±0.43)分、哮喘症状(BA)评分(1.98±0.29)分均低于对照组的(1.62±0.57)、(2.35±0.92)分,差异均具有统计学意义(P<0.05)。结论脾氨肽联合吸入糖皮质激素治疗儿童过敏性鼻炎-哮喘综合征的疗效显著,且可有效控制EOS水平,改善患儿的免疫功能与肺功能状态。

Objective To analyze the effect of spleen aminopeptide combined with inhaled corticosteroids in the treatment of children with allergic rhinitis-asthma syndrome and its influence on peripheral blood eosinophil.Methods A total of 78 children with allergic rhinitis-asthma syndrome were divided into control group and observation group according to simple random grouping method,with 39 cases in each group.The control group was treated with inhaled corticosteroids,and the observation group was treated with spleen aminopeptide combined with inhaled corticosteroids.The immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),peripheral blood T lymphocyte subsets(CD4^(+),CD8^(+)and CD4^(+)/CD8^(+))],lung function[forced expiratory volume in the first second as a percentage of predicted value(FEV1%),peak expiratory flow rate(PEFR)],eosinophil(EOS),and symptom score were compared between the two groups.Results After treatment,the IgG(10.47±1.06)g/L,IgM(7.47±0.84)g/L,IgA(7.47±0.92)g/L,CD4^(+)(40.60±3.02)%and CD4^(+)/CD8^(+)(1.94±0.19)were obviously higher than(9.01±0.84)g/L,(6.41±0.65)g/L,(6.37±0.67)g/L,(35.51±2.93)%and(1.29±0.08)of the control group,and CD8^(+)(22.47±0.75)%was obviously lower than(25.96±1.87)%of the control group.All the difference was statistically significant(P<0.05).After treatment,the FEV1%(89.97±5.08)%and PEFR(4.95±0.54)L/s of the observation group were obviously higher than(82.36±4.94)%and(4.18±0.31)L/s of the control group,and EOS(0.11±0.01)×10^(9)/L was lower than(0.39±0.02)×10^(9)/L of the control group.All the difference was statistically significant(P<0.05).The allergic rhinitis(AR)score(1.09±0.43)points and bronchial asthma(BA)score(1.98±0.29)points of the observation group were lower than(1.62±0.57)and(2.35±0.92)points of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of spleen aminopeptide and corticosteroids shows significant efficacy on children with allergic rhinitis-asthma syndrome,and it can effectively control the EOS level and improve the immune function and lung function status of children.