呼吸道病毒感染对哮喘患儿气道重塑与炎症反应的影响

Effect of respiratory virus infection on airway remodeling and inflammatory response in children with asthma

目的分析呼吸道病毒感染对哮喘患儿气道重塑与炎症反应程度的影响,为哮喘患儿诊治提供参考。方法选择2017年1月-2018年1月医院收治的哮喘合并呼吸道病毒感染患儿52例设为试验组,选择同期收治的52例单纯哮喘患儿作为对照组。检测两组患儿用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC,采用高分辨螺旋CT(HRCT)对两组患儿进行胸部扫描检查,获取患儿右上叶尖段支气管的管腔内径(ID)和外径(OD),支气管总面积(TA),管腔面积(LA),管壁厚度(WT),管壁面积(WA)等气道重塑指标,比较两组患儿中性粒细胞计数(N)、血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-4(IL-4)。结果试验组患儿肺功能指标FEV1、FEV1/FVC分别为(64.51±6.54)%、(51.47±5.35)低于对照组患儿(P<0.001)。试验组患儿HRCT显示,TA、LA、WA分别为:(27.25±4.36)mm2、(10.73±1.69)mm2、(14.95±1.42)%低于对照组患儿,而ID、OD、WT分别为(5.97±1.45)mm、(6.72±1.47)mm、(1.75±0.83)%高于对照组患儿(P<0.05);试验组患儿血清N、PCT、CRP、IL-4分别为(53.26±6.01)%、(0.51±0.09)ng/L、(31.47±4.34)ng/L、(24.58±3.28)ng/L均高于对照组患儿(P<0.05)。结论哮喘患儿合并呼吸道病毒感染会加重气道重塑及炎症反应,进一步降低患儿肺功能,临床对哮喘患儿进行诊治时,应重视合并呼吸道病毒感染的可能性,并采取抗病毒治疗促进治疗疗效。

OBJECTIVE To analyze the influence of respiratory virus infection on airway remodeling and inflammatory reaction in children with asthma,so as to provide reference for diagnosis and treatment of children with asthma.METHODS 52 children with asthma and respiratory virus infection admitted to the hospital in Jan.2017-Jan.2018 were selected as the observation group,and 52 children with simple asthma treated in the hospital in the same period were selected as the control group.Lung function-related indexes of the two groups of children were detected by lung function test apparatus,including forced vital capacity(FVC),1 second forced expiratory volume(FEV1)and FEV1/FVC.High-resolution spiral CT(HRCT)was used to scan the chest of the two groups of children,so as to obtain the internal diameter(ID)and outer diameter(OD)of the right upper leaf tip bronchus,total area of bronchus(TA),lumen area(LA),tube wall thickness(WT),tube wall area(WA),and other airway remodeling indexes.The neutrophils count(N),serum calcitonin(PCT),C reactive protein(CRP),and white medium-4(IL-4)were compared between the two groups of children.RESULTS The lung function indexes FEV1 and FEV1/FVC in the experimental group were(64.51±6.54)% and(51.47±5.35),significantly lower than those in the control group(P<0.001).HRCT showed that TA,LA and WA were(27.25±4.36)mm2,(10.73±1.69)mm2,(14.95±1.42)%,significantly lower than those of the control group,while ID,OD and WT were(5.97±1.45)mm,(6.72±1.47)mm,(1.75±0.83)%,significantly higher than those of the control group(P<0.05).N,PCT,CRP and IL-4 were(53.26±6.01)%,(0.51±0.09)ng/L,(31.47±4.34)ng/L,(24.58±3.28),significantly higher than those of the control group(P<0.05).CONCLUSION Respiratory virus infection in children with asthma can obviously aggravate airway remodeling and inflammation,and further reduce the pulmonary function of children.In the diagnosis and treatment of children with asthma,the possibility of combined respiratory virus infection should be paid attention to,and antiviral treatment should be taken to promote the therapeutic effect.