| 王雪松,潘家华.高渗盐水雾化吸入治疗中重度毛细支气管炎36例疗效观察[J].安徽医药,2019,23(1):147-151. |
| 高渗盐水雾化吸入治疗中重度毛细支气管炎36例疗效观察 |
| Clinical observation of 36 cases hypertonic saline inhalation in the treatment of moderateto severe bronchiolitis |
| 投稿时间：2017-01-12 |
| DOI： |
| 中文关键词: 细支气管炎,病毒性 盐水,高渗 干扰素γ 白细胞介素4 T淋巴细胞,调节性 儿童 |
| 英文关键词: Bronchiolitis,viral Saline solution,hypertonic Interferon-gamma Interleukin-4 T-lymphocytes,regulatory Child |
| 基金项目: |
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| 摘要点击次数: 2081 |
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| 中文摘要: |
| 目的 观察高渗盐水雾化吸入治疗不同程度毛细支气管炎的临床效果,及通过测定外周血白介素-4(IL-4)、γ-干扰素(IFN-γ)、调节性T细胞(Treg)水平的变化,探讨高渗盐水治疗毛细支气管炎可能的免疫调节作用。方法 选取2014年10月至2015年4月在安徽省立医院儿科住院诊断为毛细支气管炎患儿,根据毛细支气管炎危重度评分选取中度(A组)及重度(B组)各36例,同时选取健康体检婴幼儿12例(C组)作为健康组,A、B每组再按随机数字表分为三组,每组12例,分别给予高渗盐水(3%氯化钠)、布地奈德、异丙托溴铵雾化吸入治疗。治疗前及治疗后d4记录各患儿危重度评分,采血检测IL-4、IFN-γ、Treg,并与C组比较。结果 A组高渗盐水雾化吸入组治疗后d4患儿临床危重度评分为(3.4±1.4)分,较治疗前(6.1±1.1)分明显下降,与其余两组比较差异有统计学意义 (P<0.05)；该组治疗后外周血IL-4水平为(18.45±1.84) μg/L、IFN-γ 水平为(7.65±0.60) ng/L、Treg 比例为(10.00±0.86)%较其余两组恢复更快 (P<0.05)；B组患儿各指标在治疗后有改善,但三组组间比较差异无统计学意义(P>0.05)。结论 高渗盐水雾化吸入治疗中度毛细支气管炎临床症状改善更加明显,外周血IL-4、IFN-γ、Treg恢复更快,提示高渗盐水雾化治疗效果优于布地奈德及异丙托溴铵,具有一定的免疫调节作用；高渗盐水雾化吸入治疗重度毛细支气管炎患儿,与布地奈德及异丙托溴铵相比无明显优势。 |
| 英文摘要: |
| Objective To observe the effect of hypertonic saline inhalation therapy on children with moderate to severe bronchiolitis,and to elucidate the advantage of hypertonic saline inhalation in bronchiolitis and its potential immunomodulatory mechanism through testing the levels of IL-4,IFN-γ and percentage of regulatory Tlymphocyte (Treg) in peripheral blood.Methods Children with bronchiolitis hospitalized in our department during Oct 2014 to April 2015 were selected.Based on clinical evaluation of bronchiolitis,patients were appointed to group Awith moderate bronchiolitis and group Bwith severe bronchiolitis.There were 36 patients in each group,who were then divided randomly into 3 subgroups.Hypertonic saline (3% NaCl),budesonide,and ipratropium atomization inhalation therapy were given to each subgroup separately.The rate of respiration,and clinical manifestations of critical score,as well as the levels of IL-4,IFN-γ,Treg in blood were detected before and after treatment and campared with control group.Results On the fourth day after treatment,clinical evaluation of infants in the group treated with hypertonic saline inhalation were (3.4±1.4) points,much lower than (6.1±1.1) points before treatment.There were significant differences among the three subgroups (P<0.05).In addition,the level of IL-4 was (18.45±1.84) μg/L,the level of IFN-γ was (7.65±0.60) ng/L and the percentage of Treg was (10.00±0.86)%,which all became better after hypertonic saline inhalation.The same trend goes to patients in group Bbut without statistical differences in the subgroups (P>0.05).Conclusion Inhalation of hypertonic saline for treating infants with moderate bronchiolitis can improve clinical symptoms with the levels of IL-4,IFN-γ,and the percentage of Treg in peripheral blood lifted compared with budesonide and ipratropium bromide,suggesting that hypertonic saline may have potential immunomodulatory effects.However,it shows no advantage in treating severe bronchiolitis with hypertonic saline inhaled. |
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