高渗盐水雾化吸入治疗儿童支原体肺炎继发哮喘发作及对其T淋巴细胞亚群及Th1、Th2型细胞因子的影响

The Effect of Hypertonic Saline Inhalation on Secondary Asthma Attack in Children with Mycoplasma Pneumonia and Its Effect on T Lymphocyte Subsets and Th1 and Th2 Type Cytokines

目的:探讨高渗盐水雾化吸入治疗儿童支原体肺炎继发哮喘发作的临床疗效及对其T淋巴细胞亚群及Th1、Th2型细胞因子的影响。方法:选取我院2015年6月到2017年6月间收治的支原体肺炎继发哮喘发作患儿100例为研究对象。随机分为对照组和观察组,各50例。两组均给予吸氧、抗生素、维持酸碱度、电解质平衡及相应症状等对症治疗,对照组给予生理盐水结合沙丁胺醇进行雾化治疗,观察组采用3%高渗盐水结合沙丁胺醇进行雾化治疗,比较两组患儿发热、咳嗽、肺内啰音、咽部肿痒等症状消失时间及临床疗效;比较两组治疗前后CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、IFN-γ及IL-4水平情况。结果:观察组患儿发热、咳嗽、肺内啰音、咽部肿痒等临床症状消失时间显著早于对照组,差异有统计学意义(P<0.05);观察组总有效率96.00%明显高于对照组80.00%,差异有统计学意义(P<0.05);两组患儿治疗前CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、IFN-γ及IL-4水平比较差异无统计学意义(P>0.05);治疗后CD3^+、CD4^+、CD4^+/CD8^+及IFN-γ水平均明显升高,CD8^+及IL-4水平明显降低,差异均有统计学意义(均P<0.05);且观察组治疗后CD3^+、CD4^+、CD4^+/CD8^+及IFN-γ水平均明显高于对照组,CD8^+及IL-4水平明显低于对照组,差异均有统计学意义(均P<0.05)。结论:高渗盐水雾化吸入能够显著改善支原体肺炎继发哮喘发作患儿临床症状,提高CD3^+、CD4^+、CD4^+/CD8^+及Th1水平,抑制CD8^+及Th2水平,临床疗效确切,值得临床推广应用。

Objective:To investigate the clinical efficacy of hypertonic saline aerosol inhalation in the treatment of asthmatic attack secondary to Mycoplasma pneumonia in children and its influence on T lymphocyte subsets and Th1,Th2 cytokines.Methods:A total of 100 children with asthma secondary to Mycoplasma pneumonia admitted to our hospital from June 2015 to June 2017 were selected as subjects.They were randomly divided into the control group and the observation group,50 cases in each group.The two groups were given the symptomatic treatment of oxygen inhalation,antibiotics,maintenance of acid-base,electrolyte balance and corresponding symptoms.The control group was given saline Combination salbutamol,the observation group was given 3%hypertonic saline Combination salbutamol.The symptoms of fever,cough,rale in the lungs,and swelling of the pharynx were compared in the two groups.The levels of CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,IFN-γand IL-4 were compared between the two groups before and after treatment.Results:The disappearance time of clinical symptoms such as fever,cough,pulmonary rales,pharyngeal swelling and itching in the observation group was significantly earlier than that in the control group,the difference was statistically significant(P<0.05).The total effective rate of the observation group was 96%significantly higher than that of the control group(80%),the difference was statistically significant(P<0.05).There was no significant difference in the levels of CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,IFN-γand IL-4 before treatment in the two groups(P>0.05).After treatment,CD3^+,CD4^+,CD4^+/CD8^+and IFN-γwere significantly increased,CD8^+and IL-4 were significantly decreased,the differences were statistically significant(P<0.05);After treatment,the levels of CD3^+,CD4^+,CD4^+/CD8^+and IFN-γin the observation group were significantly higher than those in the control group,and the levels of CD8^+and IL-4 were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Atomization Iinhalation of hypertonic saline can significantly improve the clinical symptoms of Mycoplasma pneumoniae in children with asthma attacks,improve the levels of CD3^+,CD4^+,CD4^+/CD8^+and Th1,and inhibit the level of CD8^+and Th2,the clinical curative effect is exact,it is worthy of clinical application.