特布他林注射液雾化吸入联合常规药物治疗小儿支气管哮喘急性发作疗效分析

摘要

Objective:To study the clinical effect of terbutaline injection aerosol inhalation combined with conventional drug therapy for acute attack of bronchial asthma in children.Methods:Children with acute attack of bronchial asthma who were treated in Wusheng Hospital of Traditional Chinese Medicine and Qiandongnan State People's Hospital between January 2014 and July 2017 were selected as the study cases for prospective study and randomly divided into the experimental group who received terbutaline + budesonide aerosol inhalation and the control group who received budesonide aerosol inhalation.The expression levels of immune cell transcription factors in peripheral blood as well as the contents of adhesion factors,chemo-kines,proteases and their inhibitory molecules in serum were determined before treatment and 3 days after treatment.Results:Foxp3 and T-bet expression in peripheral blood as well as TIMP1 and TIMP2 contents in serum of both groups after treatment were higher than those before treatment whereas RORγt and GATA-3 expression in peripheral blood as well as TARC,Eotax-in,ICAM-1,VCAM-1,L-selectin,ADAM8,NE and MMP9 contents in serum were lower than those before treatment(P<0.05),and Foxp3 and T-bet expression in peripheral blood as well as TIMP1 and TIMP2 contents in serum of experimental group after treatment were higher than those of control group whereas ROR γt and GATA-3 expression in peripheral blood as well as TARC,Eotaxin,ICAM-1,VCAM-1,L-selectin,ADAM8,NE and MMP9 contents in serum lower than those of con-trol group(P<0.05).Conclusion:Terbutaline injection aerosol inhalation combined with conventional drug therapy can effec-tively regulate the immune response and inflammatory response and inhibit the airway remodeling mediated by protease in chil-dren with acute attack of bronchial asthma.%目的:研究特布他林注射液雾化吸入联合常规药物治疗小儿支气管哮喘急性发作的临床疗效.方法:选择武胜县中医医院及黔东南州人民医院2014年1月~2017年7月收治的支气管哮喘急性发作患儿作为研究的病例进行前瞻性研究,随机分入接受特布他林+布地奈德雾化吸入的实验组及接受布地奈德雾化吸入的对照组.治疗前及治疗后3d,测定外周血中免疫细胞转录因子表达量及血清中黏附及趋化因子、蛋白酶及其抑制分子的含量.结果:组内治疗后外周血中Foxp3、T-bet的表达量以及血清中金属蛋白酶抑制因子1(TIMP1)、TIMP2的含量高于治疗前,外周血中RORγt、GATA-3的表达量以及血清中 TARC、Eotaxin、细胞间黏附分子(ICAM)-1、血管细胞黏附分子(VCAM)-1、L-se-lectin、ADAM8、NE、基质金属蛋白酶(MMP)9的含量低于治疗前,且实验组治疗后外周血中Foxp3、T-bet的表达量以及血清中TIMP1、TIMP2的含量高于对照组,外周血中RORγt、GATA-3的表达量以及血清中TARC、Eotaxin、ICAM-1、VCAM-1、L-selectin、ADAM8、NE、MMP9的含量低于对照组.差异均有统计学意义(P<0.05).结论:特布他林注射液雾化吸入联合常规药物治疗小儿支气管哮喘急性发作能够有效调节免疫应答、炎症反应并抑制蛋白酶所介导的气道重塑.