重组干扰素α-2b 雾化治疗小儿毛细支气管炎的 疗效及对免疫功能的影响

Effect of interferon alpha 2b inhalation on the treatment and immune function of children with bronchiolitis

摘要:

目的 探讨重组干扰素α-2b 雾化治疗小儿毛细支气管炎的疗效及对免疫功能的影响。方法 选 取2016 年5 月—2017 年11 月河北省儿童医院收治的128 例毛细支气管炎患儿。采用随机数字表法分为对照 组和观察组，每组64 例。对照组采用布地奈德、异丙托溴铵雾化治疗；观察组在对照组的基础上加用重组 干扰素α-2b 雾化治疗。治疗1 周后比较两组患儿的临床疗效及4 个月内呼吸道合胞病毒（RSV）感染复发 率，以及比较两组治疗前后血清免疫球蛋白G（IgG）、免疫球蛋白A（IgA）、免疫球蛋白E（IgE）、免疫球蛋 白M（IgM）、肿瘤坏死因子-α（TNF-α）、嗜酸性粒细胞阳离子蛋白（ECP）及嗜酸性粒细胞（EOS）水平。 结果 观察组控制+ 显效合计率优于对照组（P <0.05）。两组治疗前IgG、IgA、IgE、IgM 及TNF-α 水平比较， 差异无统计学意义（P >0.05）；观察组治疗后IgE、TNF-α 水平低于对照组（P <0.05），而IgG 水平高于对 照组（P <0.05）。两组治疗后IgA、IgM 水平比较，差异无统计学意义（P >0.05）。两组治疗前ECP、EOS 比 较，差异无统计学意义（P >0.05）；观察组治疗后ECP、EOS 低于对照组（P <0.05）。随访4 个月，观察组患 儿感染复发率低于对照组（3.13% VS 15.63%）（P <0.05）。结论 重组干扰素α-2b 雾化治疗小儿毛细支气 管炎效果良好，可调节毛细支气管炎的细胞免疫和体液免疫功能、且不易复发，值得临床推广使用。

Abstract:

Objective To investigate the efficacy of interferon alpha 2b inhalation on the treatment and immune function of children with bronchiolitis. Methods A total of 128 children with bronchiolitis admitted to our hospital were randomly divided into two groups. The control group was treated with budesonide and ipratropium bromide atomization, while the observation group was treated with recombinant interferon alpha 2b inhalation. The clinical efficacy 1 week after treatment and the recurrence rate of respiratory syncytial virus (RSV) infection within 4 months were compared between the two groups. Serum levels of IgG, IgA, IgE, IgM, TNF-alpha, ECP and EOS were measured before and after treatment. Result Comparing the curative effect of the two groups, the total rate of control+marked effect in the treatment group was better than that in the control group (P < 0.05). There was no significant difference in the levels of IgG, IgA, IgE, IgM and TNF-a between the two groups before treatment (P > 0.05). The levels of IgE and TNF-a in the observation group were lower than those in the control group after treatment (P < 0.05), while IgG in the observation group were higher than that in the control group after treatment (P < 0.05). There was no significant difference in IgA and IgM between the two groups after treatment (P > 0.05). There was no significant difference in ECP and EOS between the two groups before and after treatment (P > 0.05). After treatment, ECP and EOS in the observation group were lower than those in the control group, with statistical significance (P < 0.05). The recurrence rate of infection in the treatment group (3.13%) was lower than that in the control group (15.63%) after 4 months, and the difference was statistically significant (P < 0.05). Conclusions Interferon α-2b inhalation can effectively treat bronchiolitis in children, regulate the cellular immunity and humoral immune function of bronchiolitis, which is not easy to recur. It is worthy of clinical application.