摘要
目的研究两种不同控制治疗方案对哮喘儿童气道慢性炎症的影响。方法选择2014年10月～2018年3月门诊就诊的6～14岁诊断为轻-中度哮喘或咳嗽变异性哮喘的患儿71例采用不同控制方案治疗,其中治疗组1(吸入糖皮质激素,简称ICS+口服白三烯受体拮抗剂,简称LTRA)33例;治疗组2(吸入2倍ICS)38例,在治疗的1～2个月左右,进行高渗盐水诱导痰细胞学检查(嗜酸粒细胞、中性粒细胞、巨噬细胞、淋巴细胞分类计数),并与159例正常儿童结果对照。结果痰细胞分类中各细胞组分所占百分比用中位数及四分位间距表示,治疗组1和治疗组2的患儿治疗后,嗜酸性粒细胞比例分别为0.119(0.026,0.215)、0.120(0.024,0.218)均高于正常对照0.004(0.000,0.023),差异有统计学意义;淋巴细胞比例分别为0.020 (0.008,0.034)、0.021 (0.009,0.035)与正常对照0.012(0.005,0.023)比较无显著性差异;中性粒细胞比例分别为0.159(0.012,0.350)、0.157(0.025,0.376)与正常对照0.207(0.045,0.381)比较无显著性差异;巨噬细胞比例分别为0.546(0.375,0.721)、0.544(0.370,0.720)均低于正常对照0.761(0.590,0.930),差异有统计学意义。治疗组1和治疗组2之间的痰细胞分类检查无显著性差异。结论吸入ICS+口服LTRA与吸入双倍剂量的ICS在临床上均可较好控制哮喘的症状和体征,两者对气道炎症的改善程度在痰细胞检查上暂未发现显著性差异,但从长期使用ICS的副作用方面考虑,吸入ICS联合口服LTRA方案可减少ICS的用量。
Objective To study the effects of two different control treatment regimens on chronic airway inflammation in children with asthma.Methods71children aged6to14years who were diagnosed with mild-to-moderate asthma or cough variant asthma from October2014to March2018in the outpatient department were treated with different control regimens.Treatment group1included33cases(inhaled corticosteroids,referred to as ICS+oral leukotriene receptor antagonist,referred to as LTRA).Treatment group2included38cases(inhalation of2times ICS).In the treatment of1-2months or so,hypertonic saline induced sputum cytology examination(eosinophils,neutrophils,macrophages,lymphocytes count)was taken.And the results were compared with those of159normal children.Results The percentage of each cell component in the cell classification was expressed by the median and interquartile range.After treatment in group1and group2,the eosinophil ratio was0.119(0.026,0.215),0.120(0.024,0.218),which was higher than that0.004(0.000,0.023)of the normal control,and the difference was significant.The lymphocyte ratios were0.020(0.008,0.034),0.021(0.009,0.035)and the normal control was0.012(0.005,0.023).There was no significant difference.The ratio of neutrophils was0.159(0.012,0.350),0.157(0.025,0.376),which was not significantly different from0.207(0.045,0.381)of the normal control.The ratio of macrophages was0.546(0.375,0.721),0.544(0.370,0.720),lower than the normal control of0.761(0.590,0.930),and the difference was significant.There was no significant difference in the classification of sputum cells between treatment group1and treatment group2.Conclusion Inhaled ICS+oral LTRA and double dose of ICS can well control the symptoms and signs of asthma in clinical practice.There is no significant difference in the improvement of airway inflammation between the two on the sputum cell test.But from the long-term considering of the side effects of ICS,inhaled ICS combined with oral LTRA can reduce the amount of ICS.
作者
郑菊映
陈晓东
龙莉娅
陈勇明
ZHENG Juying;CHEN Xiaodong;LONG Liya;CHEN Yongming(Department of Pediatrics,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 511447,China;Guangzhou Hospital of TCM,Guangzhou 510130,China)
出处
《中国现代医生》
2018年第33期6-9,共4页
China Modern Doctor
基金
广东省科技计划项目(粤科规划字[2013]137号)
关键词
支气管哮喘
气道炎症
控制治疗
儿童
Bronchial asthma
Airway inflammation
Control therapy
Children
