激素对难治性支原体肺炎患儿肺泡灌洗液细胞因子的影响

摘要

Objective :To explore the impact of hormone refractory mycoplasma pneumonia lavage cytokines . Methods :35 cases of children with bronchial foreign bodies not associated with infection in the control group ,90 pa‐tients were randomly divided into non‐hormonal group (45 cases) and the hormone group (45 cases) .Non‐hormonal symptomatic treatment group ,no hormone treatment ,observation group were intravenous methylprednisolone treat‐ment program ,observed the effect of hormone therapy group and the group of non‐hormonal ,cooling time ;observa‐tion group with methylprednisolone for 3 days ,all soft underwent bronchoscopy and lavage ,bronchoalveolar lavage fluid was observed in IFN ‐γ ,TNF ‐α ,IL 1β ,IL‐α ,IL‐2 ,IL‐ 4 ,IL‐6 ,IL‐8 ,IL‐10 ,IL‐12 .Results :Children with fe‐ver time hormone group ,cough disappeared significantly shorter than non‐hormonal group (P< 0 .05) ;3 days after treatment ,the hormone group had fever in 16 patients (35% ) ,None of fever in children with body temperature re‐turned to normal ,rather than the hormone group with conventional medication ;hormone group ,the total effective rate of 90 .5% was significantly higher than 79 .8% (P< 0 .05) ;after treatment ,the hormone group and hormone group lavage cytokines was not statistically significant comparison (P > 0 .05) ;the two groups and the control group ,the cytokines were significantly higher (P< 0 05) ;fever group compared to the non‐fever group of cytokines IFN‐γ ,TNF‐ α ,IL‐1β ,IL‐2 ,IL‐4 ,IL‐6 ,IL‐8 ,IL‐10 ,IL‐12 were decreased ,fever group wherein IL‐2 and IL‐8 was significantly lower than fever group (P< 0 .05) .Conclusion :The use of hormone therapy for refractory myco‐plasma pneumonia in children can bronchoalveolar lavage fluid IL‐l β ,IL‐4 ,IL‐6 ,IL‐8 ,IL‐10‐ increased ,while in a short time so that children in the fever .%目的：探讨激素对难治性支原体肺炎患儿肺泡灌洗液细胞因子的影响。方法：将难治性支原体肺炎患儿90例随机分为非激素治疗组（45例）和激素治疗组（45例），将激素组分为退热组和非退热组，另选择支气管异物但未并发感染患儿35例作为对照组。非激素治疗组仅作对症治疗；激素治疗组采用甲泼尼龙静脉滴注治疗，观察激素治疗组和非激素治疗组的临床疗效、退热时间；激素治疗组连用甲泼尼龙3d 后，所有患者行软式支气管镜与肺泡灌洗术，观察肺泡灌洗液中干扰素（IFN）‐γ、肿瘤坏死因子（TNF）‐α、白细胞介素（IL）‐1β、IL‐2、IL‐4、IL‐6、IL‐8、IL‐10、IL‐12的水平变化。结果：治疗后，激素治疗组患儿的退热时间、咳嗽消失时间明显短于非激素治疗组（ P＜0．05）；治疗3d 后，激素治疗组有16例（35％）的患儿退热，体温基本恢复正常，而非激素治疗组无1例患儿退热；激素组总有效率为90．5％，明显高于对照组的79．8％（ P ＜0．05）；治疗后，激素组和非激素组的肺泡灌洗液细胞因子比较无统计学差异（P＞0．05）；与对照组比较，细胞因子均明显高于对照组（ P＜0．05）；退热组与非退热组比较，细胞因子 IFN‐γ、TNF‐α、IL‐1β、IL‐2、IL‐4、IL‐6、IL‐8、IL‐10、IL‐12均有所降低，其中退热组的 IL‐2和 IL‐8明显低于非退热组（ P ＜0．05）。结论：采用激素治疗难治性支原体肺炎患儿，可使患儿肺泡灌洗液 IL‐l 、L‐4、IL‐6、IL‐8、IL‐10降低，同时可在较短时间内使患儿退热。