布地奈德治疗儿童 RSV 感染相关喘息的疗效及其对血清炎症介质水平的影响

摘要

Objective To observe and analyze the curative effects of budesonide treatment for the children with respiratory syncytial virus (RSV)infection associated with wheezing and its influence on the serum inflammatory mediators levels.Methods 200 patients with the first RSV infection associated with wheezing were selected as the research objects and randomly divided into the observation group and the control group with 100 patients included in each group.The patients in the two groups were treated with the basic treatment.The patients in the control group were treated with liquid aerosol Ventolin inhalation treatment on the basis of the above therapies,while the patients in the observation group were treated with the therapies of the control group combined with budesonide inhalation treatment.The respiratory improvement time,the wheezing remission time and the hospitalization time and the serum interleukin-4 (IL-4),interleukin-6 (IL-6),inter-leukin-12 (IL-12),C reactive protein (CRP),IgE levels and T lymphocytes subsets in the periph-eral blood before and after the treatment of the children in the two groups were observed and detect-ed.Meanwhile the patients were followed-up and the wheezing recurrence rates in 6 months and 1 year after the discharged day were observed .Results The respiratory improvement time ,the wheezing remission time and the hospitalization time of the children in the observation group were significantly shorter than those of the control group (P <0.05);After the treatment,the serum IL-4,IL-6,CRP,IgE levels and CD8 +T lymphocyte proportion of the children in the two groups decreased significantly compared with those before the treatment (P <0.05),while the serum IL-12 level and CD3+ T lymphocyte proportion,CD4+ T lymphocyte proportion,the ratio of CD4+ /CD8+ T lymphocyte increased significantly compared with those before the treatment (P <0.05),and the changing amplitudes of the above indexes of the patients in the observation group were significantly higher than those of control group (P <0.05);The wheezing recurrence ratios in the 6 months and 1 year after the discharged day of the patients in the observation group were significantly lower than those of the control group (P <0.05).Conclusion The curative effects of budesonide in treatment of the children with RSV infection associated with wheezing are significant.The therapy can alleviate the symptoms more quickly,improve the levels of inflam-matory mediators and reduce the probability of recurrence.%目的：观察和分析布地奈德治疗儿童呼吸道合胞病毒（RSV）感染相关喘息的疗效及其对血清炎症介质水平的影响。方法选取200例 RSV 感染相关首次喘息发作的患儿随机分为观察组和对照组，每组100例。2组患儿均给予基础对症治疗，对照组患儿在此基础上应用万托林雾化液吸入治疗，观察组患儿在对照组疗法基础上联合应用布地奈德混悬液吸入治疗。观察和检测2组患儿的呼吸改善时间、喘息缓解时间和住院时间以及治疗前、后血清白细胞介素-4（IL-4）、白细胞介素-6（IL-6）、白细胞介素-12（IL-12）、C 反应蛋白（CRP）、IgE 水平和外周血 T 淋巴细胞亚群情况进行，并对患儿出院后6个月和1年时间内的喘息发作情况进行随访和观察。结果观察组患儿的呼吸改善时间、喘息改善时间、住院时间均显著短于对照组（P＜0．05）；治疗后，2组患儿的血清 IL-4、IL-6、CRP、IgE 水平和 CD8＋T 细胞比例较治疗前显著下降（P ＜0．05），而血清 IL-12水平和 CD3＋ T 细胞比例、CD4＋T 细胞比例、CD4＋/CD8＋ T 细胞比值较治疗前显著上升（P ＜0．05），且观察组患者上述指标的变化幅度显著大于对照组（P ＜0．05）；观察组患儿出院6个月内和出院1年内喘息发作的比例均显著低于对照组（P ＜0．05）。结论布地奈德治疗儿童 RSV 感染相关喘息的疗效显著，能够快速地缓解患儿症状，显著改善患儿的炎症介质水平，并降低喘息复发的概率。