OM85-BV治疗儿童反复上呼吸道感染伴腺样体肥大的效果及对血清TNF-α、IL-6、sIL-2R水平的影响

Effect of OM85-BV in the Treatment of Children with Recurrent Respiratory Tract Infections with Adenoid Hypertrophy and Its Effect on Serum Levels of TNF-α,IL-6 and sIL-2R

目的:探讨细菌溶解产物(OM85-BV)治疗儿童反复上呼吸道感染(RRTIs)伴腺样体肥大(AH)的效果及对血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、可溶性白细胞介素-2受体(sIL-2R)水平的影响。方法:选取佳木斯市中心医院2018年1月-2020年1月收治的84例RRTIs伴AH患儿,按照随机数字表法分为两组,各42例。对照组给予孟鲁司特钠咀嚼片+糠酸莫米松鼻喷雾剂+氯雷他定糖浆治疗,观察组在对照组的基础上加用OM85-BV治疗。比较两组上呼吸道感染发作次数,腺样体厚度/鼻咽腔气道宽度(A/N)值,AH症状评分,疗效,血清TNF-α、IL-6、sIL-2R水平及不良反应发生情况。结果:治疗后,观察组上呼吸道感染发作次数、A/N值均较治疗前减少,且观察组均少于对照组(P<0.05);治疗后,两组鼻塞、打鼾、张口呼吸、腺样体面容得分均减少较治疗前,且观察组均少于对照组(P<0.05);观察组总有效率85.71%高于对照组的66.67%(P<0.05);治疗后,两组血清TNF-α、IL-6、sIL-2R水平均较治疗前降低,且观察组均低于对照组(P<0.05);两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:OM85-BV治疗儿童RRTIs伴AH可减少再发上呼吸道感染次数,抑制腺样体增生肥大,减轻鼻塞、打鼾、张口呼吸、腺样体面容等症状体征,降低血清TNF-α、IL-6、sIL-2R水平,改善预后。

Objective:To investigate the effect of bacterial lysate (OM85-BV) in the treatment of children with recurrent respiratory tract infections (RRTIs) with adenoid hypertrophy (AH) and its effect on serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),soluble interleukin-2 receptor (sIL-2R) levels.Method:A total of 84 children with RRTIs and AH admitted to Jiamusi Central Hospital from January 2018 to January 2020 were selected and divided into two groups according to the random number table method,with 42 cases in each group.The control group was treated with Montelukast Sodium Chewable Tablets + Mometasone Furoate Nasal Spray + Loratadine Syrup,and the observation group was treated with OM85-BV on the basis of the control group.The number of episodes of upper respiratory tract infection,adenoid-to-nasopharyngeal (A/N) value,AH symptom score,curative effect,serum TNF-α,IL-6,sIL-2R levels and the incidence of adverse reactions were compared.Result:After treatment,the number of episodes of upper respiratory tract infection and the A/Nvalue of the observation group were reduced compared with those before treatment,and those of the observation group was less than those of the control group (P<0.05).After treatment,the scores of nasal congestion,snoring,mouth breathing,and adenoid face decreased compared with those before treatment in the two groups,and those of the observation group were less than those of the control group (P<0.05).The total effective rate of the observation group was 85.71%,higher than 66.67% of the control group (P<0.05).After treatment,the levels of serum TNF-α,IL-6 and sIL-2R in the two groups decreased compared with those before treatment,and those of the observation group were lower than those of the control group (P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:OM85-BV in the treatment of children with RRTIs with AH can reduce the number of recurrences of upper respiratory tract infections,inhibit adenoid hyperplasia,reduce nasal congestion,snoring,open mouth breathing,adenoid facial appearance,and reduce serum TNF-α and IL-6,sIL-2R levels,improve the prognosis.