2019 年第 4 期 第 14 卷

布地奈德对呼吸道合胞病毒感染相关喘息患儿血清炎性因子水平的影响

Effect of budesonide on serum inflammatory factors in children with wheezing due to respiratory syncytial virus infection

作者：黄胜黄婷

英文作者：

单位：410007长沙，湖南中医药大学第一附属医院儿科

英文单位：

关键词：呼吸道合胞病毒感染；小儿；喘息；布地奈德

英文关键词：

• 摘要：

• 【摘要】目的    探讨布地奈德对呼吸道合胞病毒（RSV）感染相关喘息患儿血清炎性因子水平的影响。方法    选择2015年8月至2017年8月湖南中医药大学第一附属医院儿科收治的RSV感染相关喘息患儿98例,按照随机数字表法分为对照组与观察组，各49例。对照组患儿给予常规拍背吸痰、吸氧、补液、平喘、止咳联合抗病毒类药物治疗,观察组在对照组基础上联合布地奈德混悬液治疗。比较2组患儿治疗2周后的临床疗效；治疗前和治疗2周后检测2组患儿肺功能，记录潮气量、达峰容积比(VPTEF/VE)以及达峰时间比(tPTEF/tE)；采用放射免疫吸附法检测血清白细胞介素4（IL-4）、IL-6、IL-10和C反应蛋白含量。结果    治疗2周后，观察组临床总有效率显著高于对照组［95.9%（47/49）比81.6%（40/49）］，差异有统计学意义（P＜0.05）。治疗前，2组患儿肺功能相关指标水平比较差异均无统计学意义（均P＞0.05）。治疗后，2组患儿潮气量、VPTEF/VE以及tPTEF/tE均高于治疗前，且观察组高于对照组［（8.7±2.6）ml/kg比（7.4±2.1）ml/kg，（29±7）%比（24±6）%，（30±6）%比（23±4）%］，差异均有统计学意义（均P＜0.05）。治疗前，2组患儿血清炎性因子水平比较差异均无统计学意义（均P＞0.05）。治疗后，2组患儿血清IL-4、IL-6及C反应蛋白水平均低于治疗前，且观察组低于对照组［（7.6±1.4）ng/L比（12.3±2.4）ng/L，（15.6±2.4）ng/L比（21.3±5.4）ng/L，（6.4±1.1）mg/L比（9.0±1.2）mg/L］；IL-10水平均高于治疗前，且观察组高于对照组［（14.0±3.0）ng/L比（9.4±1.9）ng/L］，差异均有统计学意义（均P＜0.05）。结论    常规治疗联合布地奈德治疗RSV感染相关喘息效果显著，能够有效抑制气道炎症。

• 【Abstract】Objective    To investigate the effect of budesonide on serum inflammatory factors in children with wheezing due to respiratory syncytial virus infection. Methods    A total of 98 children with RSV infection-related wheezing admitted to the First Hospital of Hunan University of Chinese Medicine from August 2015 to August 2017 were enrolled. They were randomly divided into control group and observation group, with 49 cases in each group. The control group was treated with conventional back-sucking, oxygen-absorbing, rehydration, anti-asthmatic, anti-tussive and anti-viral drugs. The observation group was treated with budesonide suspension on the basis of control group. Clinical efficacy, lung function［tidal volume, peak volume ratio(VPTEF/VE), peak time ratio(tPTEF/tE)］, serum levels of interleukin-4(IL-4), IL-6, IL-10 and C-reactive protein（radioimmunosorbent assay） were analyzed. Results    After 2 weeks of treatment, the total clinical effective rate in the observation group was significantly higher than that in the control group［95.9%(47/49) vs 81.6%(40/49)］(P<0.05). Before treatment, there was no significant difference of lung function indexes between groups(P>0.05). After treatment, tidal volume, VPTEF/VE and tPTEF/tE significantly increased; the indexes in the observation group were significantly higher than those in the control group［(8.7±2.6)ml/kg vs (7.4±2.1)ml/kg, (29±7)% vs (24±6)%, (30±6)% vs (23±4)%］(P<0.05). Before treatment, there was no significant difference of serum inflammatory factors between groups(P>0.05). After treatment, levels of serum IL-4, IL-6, C-reactive protein decreased and IL-10 level increased; IL-4, IL-6 and C-reactive protein in the observation group were significantly lower than those in the control group［(7.6±1.4)ng/L vs (12.3±2.4)ng/L, (15.6±2.4)ng/L vs (21.3±5.4)ng/L, (6.4±1.1)mg/L vs (9.0±1.2)mg/L］; IL-10 in the observation group was significantly higher than that in the control group［(14.0±3.0)ng/L vs (9.4±1.9)ng/L］(P<0.05). Conclusion    Budesonide is effective in the treatment of RSV infection-related wheezing and it can significantly inhibit airway inflammation.