维生素AD滴剂联合糖皮质激素吸入治疗小儿支原体肺炎的效果及对免疫功能的影响

Effect of Vitamin AD Drops combined with glucocorticoid inhalation in the treatment of mycoplasma pneumonia in children and its effect on immune function

目的观察维生素AD滴剂联合糖皮质激素吸入治疗小儿支原体肺炎的效果及对免疫功能的影响。方法选取江苏省无锡市妇幼保健院2018年1月至2019年10月收治的92例小儿支原体肺炎患儿为研究对象,采用单双数标记法分为两组,每组46例。两组均给予阿奇霉素治疗,糖皮质激素组加用糖皮质激素吸入治疗,联合组在糖皮质激素组基础上联合维生素AD滴剂治疗,疗程为2周。比较两组临床疗效;比较两组症状及体征改善时间、免疫功能、调节性T细胞/辅助性T细胞17(Treg/Th17);随访1年,记录两组复发情况。结果糖皮质激素组脱落3例,最终入组43例。联合组退热、憋喘消失、止咳及湿啰音消失时间短于糖皮质激素组(P<0.05);两组肺部阴影消失时间比较,差异无统计学意义(P>0.05)。治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于治疗前,CD8^(+)低于治疗前,且联合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于糖皮质激素组,CD8^(+)低于糖皮质激素组(P<0.05)。治疗后,Treg、Treg/Th17高于治疗前,Th17低于治疗前,且联合组Treg、Treg/Th17高于糖皮质激素组,Th17低于糖皮质激素组(P<0.05)。两组临床疗效比较,差异无统计学意义(P>0.05)。联合组复发率低于糖皮质激素组,复发时治疗时间短于糖皮质激素组(P<0.05)。结论维生素AD滴剂联合糖皮质激素吸入治疗小儿支原体肺炎可促进症状及体征的消失,减少复发,可能与调节免疫功能有关。

Objective To observe the effect of Vitamin AD Drops combined with glucocorticoid inhalation in the treatment of mycoplasma pneumonia in children and its effect on immune function.Methods A total of 92 children with mycoplasma pneumonia in children admitted to Wuxi Maternal and Child Health Hospital,Jiangsu Province from January 2018 to October 2019 were selected as study subjects.They were divided into two groups by odd-even number labeling method,with 46 cases in each group.Both groups were treated with Azithromycin,the glucocorticoid group were treated with inhalation glucocorticoid,and combined group were treated with Vitamin AD Drops based on glucocorticoid group,the course of treatment was two weeks.The clinical effect of two groups was compared;symptoms and signs improvement time,immune function,regulatory T cells/helper T cells 17(Treg/Th17)were compared between two groups;patients were followed up for one year and the recurrence was recorded in both groups.Results In glucocorticoid group,three cases were shed,and 43 cases were enrolled.The disappearance time of fever,asthma,cough,and wet rales in combination group was shorter than that in glucocorticoid group(P<0.05);there was no significant difference in the time of lung shadow disappearance between two groups(P>0.05).After treatment,CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in both groups were higher than those before treatment,and CD8^(+)was lower than that before treatment,and CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in combination group were higher than those in glucocorticoid group,and CD8^(+)was lower than that in glucocorticoid group(P<0.05).After treatment,Treg and Treg/Th17 were higher than those before treatment,and Th17 was lower than that before treatment,and Treg and Treg/Th17 in combination group were higher than those in glucocorticoid group,and Th17 was lower than that in glucocorticoid group(P<0.05).There was no significant difference in clinical efficacy between two groups(P>0.05).The recurrence rate of combined group was lower than that of glucocorticoid group,and the treatment time when recurrence was shorter than that of glucocorticoid group(P<0.05).Conclusion Vitamin AD Drops combined with glucocorticoids can promote the disappearance of symptoms and signs and reduce recurrence of mycoplasma pneumonia in children,which may be related to the regulation of immune function.