重组干扰素α2b联合沙丁胺醇治疗嗜酸性粒细胞性支气管炎的疗效研究

Efficacy of Recombinant Interferonα2b Combined with Salbutamol in the Treatment of Eosinophilic Bronchitis

探讨重组干扰素α2b联合沙丁胺醇治疗小儿嗜酸性粒细胞性支气管炎(EB)的疗效及对血清炎症指标的影响。选择304例EB患儿,并采用随机数字表法将以上病例随机分为对照组和观察组,每组152例,对照组给予硫酸沙丁胺醇溶液,观察组基于对照组用药上加予重组人干扰素α-2b注射液,比较两组患儿治疗前、治疗5 d及治疗2 w后的咳嗽症状积分、视觉模拟评分法(VAS)评分及痰嗜酸性粒细胞(Eosinophils,EOS)变化,观察两组体征症状消失时间,评估两组患儿的临床疗效,记录两组随访半年后的复发率,对比两组治疗前、治疗5 d及治疗2 w后的血清白介素-10(IL-10)、白介素-18(IL-18)水平,评价两组用药期间的不良反应。治疗5 d及治疗2 w后,两组患儿关于咳嗽症状积分、VAS评分及痰EOS的时间点效应、组间效应及时间点与组间效应对比,差异均有统计学意义(P<0.05),均显著低于治疗前(P<0.05),观察组显著低于对照组(P<0.05);观察组的咳嗽痰响消失时间、肺部啰音消失时间、体温恢复时间及住院时间均显著短于对照组(P<0.05);观察组的临床总有效率显著高于对照组(95.39%vs 82.24%,P<0.05),治疗半年后的复发率显著低于对照组(1.32%vs 5.92%,P<0.05);治疗5 d及治疗2 w后,两组患儿关于血清IL-10、IL-18水平的时间点效应、组间效应及时间点与组间效应对比,差异均有统计学意义(P<0.05),两组血清IL-10水平显著高于治疗前(P<0.05),血清IL-18水平显著低于治疗前(P<0.05),组间治疗后同时间点比较均具备显著性差异(P<0.05);两组的不良反应总发生率对比,差异无统计学意义(1.97%vs 3.29%,P>0.05)。重组干扰素α2b联合沙丁胺醇治疗EB患儿能明显改善患儿的咳嗽、疼痛评分,降低痰EOS计数,促进患儿快速康复出院,提高临床疗效,并降低半年后的复发率,同时能改善血清炎症指标。

To investigate the efficacy of recombinant interferonα2b combined with albuterol in the treatment of children with eosinophilic bronchitis(EB)and the effect on serum inflammatory indexes,304 children with EB were selected,and the above cases were randomly divided into control group and observation group by random number table method,152 cases in each group.Suα-2b injection was used to compare the cough symptom scores,visual analogue scale(VAS)scores and sputum eosinophils(EOS)before treatment,5 days after treatment and 2 weeks after treatment between the two groups.The disappearance time of signs and symptoms in the two groups was evaluated,the clinical efficacy of the two groups was evaluated,the recurrence rate after six months of follow-up in the two groups was recorded,and the serum levels of interleukin-10(IL-10),-18(IL-18)level,and the adverse reactions during the two groups were evaluated.After 5 days of treatment and 2 weeks of treatment,there were statistically significant differences in the time-point effect,between-group effect and time-point and between-group effect of cough symptom score,VAS score and sputum EOS between the two groups(P<0.05),which were significantly lower than those before treatment(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The cough sputum disappearance time,lung rales disappcarence time,temperature recovery time and length of stay in the observation group were significantly shorter than the control group(P<0.05);the total clinical effective rate of the observation group was significantly higher than that of the control group(95.39%vs 82.24%,P<0.05),and the recurrence rate after half a year of treatment was significantly lower than that of the control group(1.32%vs 5.92%,P<0.05);after 5 days of treatment and 2 weeks after treatment,the time-point effect,between-group effect,and time-point and between-group effect on serum IL-10 and IL-18 levels in the two groups of children were significantly different,there were statistical significance(P<0.05).The serum IL-10 levels in the two groups were significantly higher than those before treatment(P<0.05),and the serum IL-18 levels were significantly lower than those before treatment(P<0.05).There were significant differences between time points(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(1.97%vs 3.29%,P>0.05).Recombinant interferonα2b+salbutamol in the treatment of EB children can significantly improve the cough and pain,reduce the sputum EOS count,promote the rapid recovery and discharge of the children,improve the clinical efficacy,reduce the recurrence rate after half a year,and improve the serum inflammatory indexes.