摘要
目的 探讨布地奈德雾化吸入联合甲泼尼龙对支原体肺炎（MPP）患儿T淋巴细胞亚群细胞因子表达及免疫功能的影响.方法 选取2015年8月至2016年9月84例MPP患儿,通过随机数字表法进行分组,每组42例.对照组采用布地奈德雾化吸入治疗,研究组采用布地奈德雾化吸入＋静脉滴注甲泼尼龙,两组均持续治疗7 d.统计对比两组临床疗效,对比治疗前后两组免疫功能指标（IgA、IgM、IgG）、T淋巴细胞亚群细胞因子[CD3＋、CD4＋、CD8＋、CD4＋/CD8＋]及血清炎性因子指标[肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）、IL-4、干扰素-γ（IFN-γ）]水平变化情况.结果 ①临床疗效：研究组总有效率（92.86%）高于对照组（76.19%）,差异有统计学意义（P〈0.05）;②免疫功能：治疗前两组IgA、IgM、IgG水平比较差异未见统计学意义（P〉0.05）,治疗后两组各指标水平较治疗前降低,且研究组IgA、IgM、IgG水平低于对照组,差异有统计学意义（P〈0.05）;③T淋巴细胞亚群细胞因子：治疗前两组CD3＋、CD4＋、CD8＋、CD4＋/CD8＋水平比较差异未见统计学意义（P〉0.05）,治疗后两组各指标水平较治疗前改善,且研究组CD3＋、CD4＋、CD4＋/CD8＋水平高于对照组,CD8＋水平低于对照组,差异有统计学意义（P〈0.05）;④血清炎性因子：治疗前两组TNF-α、IL-2、IL-4、IFN-γ水平比较差异未见统计学意义（P〉0.05）,治疗后两组各指标水平较治疗前明显改善,且研究组TNF-α、IL-2、IFN-γ水平低于对照组,IL-4水平高于对照组,差异有统计学意义（P〈0.05）.结论 采用布地奈德雾化吸入联合甲泼尼龙治疗小儿支原体肺炎患者效果显著,可有效降低炎性因子水平,减轻炎性反应,调节机体免疫功能,提高治疗效果,值得临床推广应用.
Objective To investigate the effect of inhaled budesonide combined with methylprednisolone on cytokine expression and immune function of T lymphocyte subsets in children with mycoplasma pneumonia.Methods From August 2015 to September 2016, 84 cases of MPP were selected and grouped by random number table method, with 42 cases in each group.The control group received inhaled budesonide treatment, and the study group received inhaled budesonide and intravenous methylprednisolone, both groups were treated for 7 days.The clinical effects of the two groups were compared by statistics, before and after treatment, the immune function indexes （IgA, IgM, IgG） and T lymphocyte subsets and cytokines [CD3＋,CD4＋,CD8＋,CD4＋/CD8＋] and serum inflammatory factors [tumor necrosis factor alpha （TNF-alpha） and interleukin-2 （IL-2）, IL-4 and interferon gamma （IFN-γ） changes] levels were compared.Results ① Clinical effect： the total effective rate of the study group （92.86%） was higher than that of the control group （76.19%）, the difference was significant （P〈0.05）;② Immune function： there was no significant difference in IgA, IgM or IgG levels before treatment （P〉0.05）, each index level of the two groups was lower after treatment than those before the treatment, and IgA, IgM, IgG levels in the study group was lower than those in the control group, the differences were significant （P〈0.05）;③ T lymphocyte subsets cytokine： there was no significant difference in the levels of CD3＋,CD4＋,CD8＋,CD4＋/CD8＋ between the two groups before treatment （P〉0.05）.After treatment, the indexes of the two groups were improved than those before treatment, and the levels of CD3＋,CD4＋,CD8＋,CD4＋/CD8＋ in the study group were higher than those in the control group, the CD8＋ level was lower than that in the control group, the differences were significant （P〈0.05）.④ Serum inflammatory factors： there was no significant difference in the levels of TNF-α, IL-2, IL-4 and IFN-γ between the two groups before treatment（P〉0.05）.After treatment, the indexes of the two groups were improved than those before treatment, and the levels of ITNF-α, IL-2, IL-4 or IFN-γ in the study group were lower than those in the control group, the level of IL-4 was higher than that in the control group, the differences were significant （P〈0.05）.Conclusions The effect of inhaled budesonide combined with methylprednisolone on cytokine expression and immune function of T lymphocyte subsets in children with mycoplasma pneumonia is significant, it can effectively reduce the levels of inflammatory factors, reduce inflammation, regulate immune function, improve the therapeutic effect, so it is worthy of promotion.
出处
《中国实用医刊》
2017年第15期89-93,共5页
Chinese Journal of Practical Medicine
