雾化吸入对小儿哮喘调节性 T 细胞及气道炎症的治疗效果

摘要

Objective To observe the therapeutic effects of combination trigeminy atomization inhalation of budesonide (BUD), salbutamol (SAL) and ipratropium bromide (IB) on bronchial asthma in children and its effects on regulatory T cells and airway inflammation.Methods Forty children patients with bronchial asthma were randomly divided into two groups,with 20 patients in each group.The patients in observation group were treated by triple atomization inhalation of BUD,SAL and IB,however,the patients in control group were treated by oral Vitamin B1 (placebo),10mg/d.The srum levels of IFN-γand IL-4 in peripheral blood of patients were detected,the severity of bronchial asthma was evaluated according to asthma symptom scoring,and lung function was compared between two groups by FEV1 comparison method.The parameters about lung function were observed before treatment and on 1m,3m,6m after treatment for both groups.Moreover the pleural thickness and pleural sliding degree were detected after treatment.Results As compared with those in control group, the FEV1 was obviously improved,and the percentage of Th2 was significantly decreased in observation group ( P <0.05). Moreover the disbalance of Th1/Th2 and Treg/Th17 was significantly improved in observation group ( P <0.05).There were no significant differences in lung functions before treatment and on 1m,3m after treatment between two groups ( P >0.05). However the lung functions on 6m after treatment in observation group were superior to those in control group ( P <0.05). CT examination results showed that pleural thickness in observation group was thicker than that in control group,and pleural sliding degree in observation group was superior to that in control group ( P <0.05).Conclusion The atomization inhalation can balance cytokines again, regulate the balance of Th1/Th2 and Treg/Th17,improve lung function of patients,thus, which can relieve the symptoms of asthma.%目的：观察并探讨布地奈德（ BUD）、沙丁胺醇（ SAL）和异丙托溴铵（ ipratropium bromide，IB）三联雾化吸入治疗对小儿支气管哮喘调节性T细胞及气道炎症的影响。方法分析儿童支气管哮喘患者40例，随机平均分为2组，哮喘组采用BUD、SAL联合IB三联雾化吸入治疗，对照组口服维生素B1（安慰剂），10 mg／d。收集外周血样，测定IFN-γ和IL-4的水平。哮喘严重度由哮喘症状评分评估，肺功能比较用FEV1比较。观察2组患者治疗前及药物治疗后1个月、3个月、6个月的肺功能各项指标的情况，2组治疗后检测胸膜厚度及胸膜滑动度。结果哮喘组FEV1显著改善，Th2细胞百分比显著降低（ P ＜0*．05）。哮喘组Th1细胞与Treg细胞略有变化，从而减轻Th1／Th2细胞和Treg／Th17细胞的失衡，对照组无明显变化（ P ＞0．05）；2组治疗前及治疗后1个月、3个月肺功能差异无统计学意义（ P ＞0．05）；6个月肺功能哮喘组优于对照组，2组差异有统计学意义（ P ＜0．05）；哮喘组术后CT测量胸膜厚度要厚于对照组，胸膜滑动度优于对照组，差异有统计学意义（ P ＜0．05）。结论雾化吸入重新平衡细胞因子，调节Th1／Th2细胞和Treg／Th17细胞平衡，改善患者肺功能，从而缓解哮喘患者症状。