重组干扰素α-2β雾化吸入联合口服维生素D对毛细支气管炎患儿血清PDGF、ECP和尿LTE4水平的影响-东南大学学报医学版

重组干扰素α-2β雾化吸入联合口服维生素D对毛细支气管炎患儿血清PDGF、ECP和尿LTE4水平的影响

单位：1. 淮南市第一人民医院儿科, 安徽淮南 232007;
2. 安徽理工大学医学院, 安徽淮南 232001

关键词：重组干扰素α-2β 毛细支气管炎维生素D 血小板衍生因子人嗜酸粒细胞阳离子蛋白白三烯E4 小儿

分类号：R725.6

出版年·卷·期（页码）：2019·38·第六期（1006-1011）

摘要：

目的：探讨重组干扰素α-2β雾化吸入联合口服维生素D对毛细支气管炎患儿血清血小板衍生因子（PDGF）、人嗜酸粒细胞阳离子蛋白（ECP）、白介素-4（IL-4）、γ干扰素（IFN-γ）和尿白三烯E4（LTE4）水平的影响，旨在为临床治疗提供实验依据。方法：选择2017年4月至2018年3月淮南市第一人民医院儿科收治的60例毛细支气管炎患儿，随机分为观察组和对照组，各30例。对照组给予毛细支气管炎常规治疗并口服维生素D，观察组在对照组治疗基础上加用重组人干扰素α-2β注射液雾化吸入。比较两组的临床疗效，患儿治疗前及治疗5、12 d的血清PDGF、ECP、IL-4、IFN-γ和尿LTE4水平。结果：观察组总有效率为93.33%，对照组总有效率为73.33%，两组差异有统计学意义（P < 0.05）。治疗前，两组血清PDGF、ECP、IL-4和IFN-γ和尿LTE4水平均差异均无统计学意义（均P > 0.05）；治疗5 d两组血清PDGF、ECP、IL-4和尿LTE4水平均有所下降，IFN-γ水平均有所上升，但两组差异无统计学意义（P > 0.05）；治疗12 d两组血清PDGF、ECP、IL-4和尿LTE4水平均有所下降，观察组下降更明显，IFN-γ水平均有所上升且比对照组上升更明显，差异有统计学意义（均P < 0.05）。观察组患儿住院时间、咳嗽痰鸣消失时间、肺部干湿性啰音消失时间及体温恢复正常时间均明显短于对照组，差异均有统计学意义（均P < 0.05）。结论：重组干扰素α-2β雾化吸入联合口服维生素D治疗患儿毛细支气管炎效果良好，能有效改善患儿机体炎症状态、临床症状及体征，正向调节患儿机体免疫功能。

Objective: To investigate the effect of recombinant interferon α-2β inhalation combined with oral vitamin D on serum platelet derived growth factor(PDGF) and human eosinophilic cationic protein(ECP), interleukin-4(IL-4), interferon-γ(IFN-γ), and urinary leukotriene E4(LTE4) levels in children with bronchiolitis. Methods: Sixty children with bronchiolitis admitted to the Department of Pediatrics, the First People's Hospital of Huainan from April 2017 to March 2018 were randomly divided into 2 groups:the observation group and control group, 30 cases in each group. The control group received routing treatment of bronchiolitis and oral administration of vitamin D. The observation group was treated with the recombinant human interferon α-2β injection by nebulization on the bases of the control group. The clinical efficacy, the serum PDGF, ECP, IL-4, IFN-γ and urinary LTE4 levels in pre-treatment, treatment 5 days and 12days were detected and compared between the two groups. Results: The efficacy of the observation group was 93.33%, and the control group was 73.33%. The difference was statistically significant(P < 0.05). The serum PDGF, ECP, IL-4 and IFN-γ and urinary LTE4 of the two groups had no statistically differences before treatment(P > 0.05). The levels of serum PDGF, ECP, IL-4 and urinary LTE4 had decreased and IFN-γ all increased 5 days after treatment, but there were no significant differences between the two groups(all P > 0.05). The serum PDGF, ECP, IL-4 and urinary LTE4 levels of the two groups decreased 12 days after treatment,and the decline was more obvious in the observed group,the serum IFN-γ increased, and the increase was more obvious in the observed group, the differences were statistically significant(P < 0.05). The hospitalization time, the disappearance time of cough and snoring, the disappearance time of dry and wet sputum in the lungs, and the time of body temperature returning to normal had significantly shorted than those in the control group,the differences were statistically significant(P < 0.05). Conclusion: Recombinant interferon α-2β aerosol inhalation combined with oral vitamin D is effective in treating bronchiolitis in children and can effectively improve the inflammatory state and clinical symptoms and signs, positively regulate the immune function of children.

参考文献：

[1] 尚云晓,黄英,刘恩梅,等.雾化吸入重组人干扰素α1b治疗小儿急性毛细支气管炎多中心研究[J].中国实用儿科杂志,2014,29(11):840-844.
[2] 王俭,李益,杨婕,等.干扰素联合布地奈德治疗毛细支气管炎的疗效分析[J].现代医学,2015,43(10):1275-1277.
[3] 李延琪,王立军.异丙托溴铵联合沙丁胺醇及布地奈德雾化吸入治疗小儿毛细支气管炎疗效观察[J].儿科药学杂志,2013,19(3):12-14.
[4] 李静.布地奈德联合复方异丙托溴铵雾化吸入治疗小儿毛细支气管炎疗效观察及其对血清PCT、hs-CRP的影响[J].临床和实验医学杂志,2015,14(19):1641-1643.
[5] 刘玉慧,代运磊,相恒杰,等.毛细支气管炎患儿血清25-(OH)-D3水平、尿LTE4水平变化的临床意义及维生素D3干预对尿LTE4的影响[J].临床肺科杂志,2016,21(1):91-94.
[6] 迟春天,周建,鲍永霞,等.AECOPD与ACOS患者血浆中CRP、IL-8、IL-10、TNF-α炎性细胞因子水平的临床对比研究[J].现代医学,2017,45(9):1252-1255.
[7] 王利霞.双嘧达莫片联合孟鲁司特钠咀嚼片治疗呼吸道合胞病毒感染毛细支气管炎患儿的临床疗效[J].临床研究,2019,27(6):135-136.
[8] 于天狐.呼吸道合胞病毒毛细支气管炎患儿血ECP和尿LTE4水平与临床评分的关系[J].临床和实验医学杂志,2016,15(4):347-350.
[9] 侯秀玲,王敬敏,刘冬梅,等.LTE4和鼻咽分泌物ECP对毛细支气管炎治疗和预后的影响[J].检验医学与临床,2015,12(24):3637-3638,3642.[ZK)]
[10] 曾静好,黎进飞,赖永艺,等.重组人干扰素α-2b注射液雾化吸入治疗小儿毛细支气管炎的疗效观察[J].吉林医学,2016,37(6):1319-1321.
[11] 胡亚美,江载芳.诸福棠实用儿科学(上册)[M].7版.北京:人民卫生出版社,2002:1174-1215.
[12] LU Q B,WAN M Y,WANG P Y,et al.Chicoric acid prevents PDGF-BB-induced VSMC dedifferentiation,proliferation and migration by suppressing ROS/NFκB/mTOR/P70S6K signaling cascade[J].Redox Biol,2018,14(4):656-668.
[13] RABINOVITCH N,JONES M J,FAINO A,et al.cysteinyl leukotriene receptor 1 and health effects of particulate exposure in asthma[J].Ann Am Thorac Soc,2018,15(Supplement 2):S129.
[14] MOGENSEN I,ALVING K,BJERG A,et al.Simultaneously elevated exhaled nitric oxide and serum-eosinophil cationic protein relate to recent asthma events in asthmatics in a cross-sectional population-based study[J].Clin Exp Allergy,2016,46(12):1540-1548.
[15] LEE Y J,FUJISAWA T,KIM C K.Biomarkers for recurrent wheezing and asthma in preschool children[J].Allergy Asthma Immunol Res,2019,11(1):16-28.
[16] 李兰,蒋虹,张立,等.孟鲁司特治疗对婴幼儿呼吸道合胞病毒毛细支气管炎气管炎症和再次喘息的影响[J].中国呼吸与危重监护杂志,2013,12(2):186-189.
[17] 康利娜,成芳,安红,等.雾化吸入重组人干扰素α1b治疗小儿毛细支气管炎的临床观察[J].中国药房,2016(6):758-760.
[18] 郑爱英.孟鲁司特钠佐治小儿毛细支气管炎的疗效及其对机体免疫学指标的影响[J].中国临床研究,2015,28(6):723-726.
[19] 于天狐.呼吸道合胞病毒毛细支气管炎患儿血ECP和尿LTE4水平与临床评分的关系[J].临床和实验医学杂志,2016(4):347-350.
[20] 吴奎,袁北芳,侯学敬,等.毛细支气管炎患儿单核细胞Toll样受体-4的表达与维生素D水平变化的关系[J].中华实用儿科临床杂志,2015,30(12):938-940.
[21] 刘钢铁,薛月玲,杨爱青,等.毛细支气管炎患儿血清25-(OH) D_3、LL-37水平变化及意义[J].山东医药,2016,56(8):75-77.
[22] 苏畅,汤永民.毛细支气管炎患儿25-羟维生素D3、TIgE及相关细胞因子水平检测分析[J].中国妇幼保健,2016,31(4):751-753.
[23] 张玉荣,林子玉.孟鲁司特钠片联合维生素D治疗婴幼儿毛细支气管炎的临床效果研究[J].齐齐哈尔医学院学报,2017,38(22):2605-2608.

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