维生素A、D辅治肺炎支原体肺炎患儿及对血清T细胞亚群、IL-13、CysLTs的影响

Effects of Vitamin A and Vitamin D on serum T cell subsets, IL-13 and CysLTs in children with mycoplasma pneumoniae pneumonia

目的研究维生素A、D(VA、VD)辅治肺炎支原体肺炎(MPP)患儿及对血清T细胞亚群、白细胞介素-13(IL-13)、半胱氨酰白三烯(CysLTs)的影响。方法回顾性选择2019年1月至2021年12月上海交通大学附属第六人民医院收治的MPP患儿92例,按照治疗方法的不同将92例MPP患儿分为实验组(n=46)与对照组(n=46)。对照组行常规治疗^(+)阿奇霉素^(+)盐酸氨溴索治疗,实验组在对照组基础上行VA、VD治疗,7 d为1个疗程,共治疗1个疗程。观察两组临床症状消失时间及住院时间,两组治疗前及治疗7 d后最大呼气流量(PEF)、1 s用力呼气量(FEV1)及用力肺活量(FVC)等肺功能指标;血清CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)等T细胞亚群水平;血清IL-13、CysLTs水平及治疗期间不良反应。结果实验组的退热时间、肺部症状消失时间咳嗽消失时间及住院时间分别为(2.62±0.30)、(5.27±0.55)、(8.30±0.86)、(9.35±0.98)d,均小于对照组[(2.98±0.32)、(6.31±0.66)、(9.68±1.02)、(10.82±1.36)d],差异均有统计学意义(P<0.05)。治疗期间两组均无显著不良反应。治疗7 d后,实验组的PEF、FEV1、FVC及CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平分别为(2.51±0.28)mL、(1.68±0.19)mL、(1.52±0.18)mL、(68.85±7.19)%、(38.26±4.16)%、(1.77±0.19),均高于对照组[(1.96±0.22)mL、(0.74±0.09)mL、(1.83±0.20)mL、(63.72±6.60)%、(33.52±3.63)%、(1.35±0.16)],CD8^(+)及IL-13、CysLTs水平分别为(21.62±2.39)%、(98.85±10.27)ng/mL、(782.06±80.18)pg/mL,均低于对照组[(25.09±2.77)%、(129.57±15.06)ng/mL、(979.32±99.08)pg/mL],差异均有统计学意义(P<0.05)。结论VA、VD辅治MPP患儿可改善临床症状,增强肺功能,改善血清T细胞亚群水平,抑制IL-13、CysLTs生成,且安全性高。

Objective To study the effects of Vitamin A and Vitamin D on serum T cell subsets,interleukin-13(IL-13),cysteinyl leukotrienes(CysLTs)in children with mycoplasma pneumoniae pneumonia(MPP).Methods A total of 92 children with MPP admitted to the Shanghai Jiao Tong University Affiliated Sixth People's Hospital from January 2019 to December 2021 were retrospectively selected and divided into experimental group(n=46)and control group(n=46)according to treatment method.The control group received conventional treatment^(+)azithromycin^(+)ambroxol hydrochloride.The experimental group received Vitamin A and Vitamin D treatment on the basis of the control group,7 d was 1 course,1 course of treatment in total.The clinical symptoms disappeared and the length of hospital stay were observed.The pulmonary function indexes including maximum expiratory flow(PEF),forced expiratory volume in 1 second(FEV1)and forced vital capacity(FVC)before and 7d after treatment were observed.Serum CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)T cell subsets;Serum IL-13 and CysLTs levels and adverse reactions during treatment.Results The antipyretic time,the time of disappearance of pulmonary symptoms,the time of disappearance of cough and the time of hospitalization in the experimental group were(2.62±0.30),(5.27±0.55),(8.30±0.86),(9.35±0.98)days,which were less than those in the control group[(2.98±0.32),(6.31±0.66),(9.68±1.02),(10.82±1.36)days],and the differences were statistically significant(P<0.05).There were no significant adverse reactions in both groups during treatment.After 7 d of treatment,the levels of PEF,FEV1,FVC and CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the experimental group were(2.51±0.28)mL,(1.68±0.19)mL,(1.52±0.18)mL,(68.85±7.19)%,(38.26±4.16)%,(1.77±0.19),respectively,higher than those in the control group[(1.96±0.22)mL,(0.74±0.09)mL,(1.83±0.20)mL,(63.72±6.60)%,(33.52±3.63)%,(1.35±0.16)],CD8^(+)and IL-13 and CysLTs were(21.62±2.39)%,(98.85±10.27)ng/mL,(782.06±80.18)pg/mL were lower than those in the control group[(25.09±2.77)%,(129.57±15.06)ng/mL,(979.32±99.08)pg/mL],the differences were statistically significant(P<0.05).Conclusion VA and VD can improve the clinical symptoms,enhance lung function,improve the level of serum T cell subsets,and inhibit the generation of IL-13 and CysLTs in children with MPP,with high safety.