| 陈 亮,李 宏,白 珺,廖 旺,陈国华.皮下免疫治疗联合沙美特罗替卡松粉吸入剂对中度支气管哮喘缓解期患儿血清Th1/Th2相关细胞因子表达水平的影响[J].现代生物医学进展英文版,2023,(9):1671-1675. |
| 皮下免疫治疗联合沙美特罗替卡松粉吸入剂对中度支气管哮喘缓解期患儿血清Th1/Th2相关细胞因子表达水平的影响 |
| Effect of Subcutaneous Immunotherapy Combined with Salmetroticasone Powder Inhalant on the Expression of Serum Th1/Th2-Related Cytokines in Children with Moderate Bronchial Asthma in Remission Stage |
| Received:September 24, 2022 Revised:October 20, 2022 |
| DOI：10.13241/j.cnki.pmb.2023.09.014 |
| 中文关键词: 儿童 支气管哮喘 皮下免疫治疗 沙美特罗替卡松粉吸入剂 Th1/Th2相关细胞因子 |
| 英文关键词: Children Bronchial asthma Subcutaneous immunotherapy Salmetroticasone powder inhalant Th1/Th 2-related cytokines |
| 基金项目:广东省医学科学技术研究基金项目（A2021464） |
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| 中文摘要: |
| 摘要 目的：探讨皮下免疫治疗联合应用沙美特罗替卡松粉吸入剂治疗中度支气管哮喘缓解期患儿的临床疗效及对Th1/Th2相关细胞因子表达水平的影响。方法：选取南方医科大学佛山市妇幼保健院2020年1月～2020年12月收治的中度支气管哮喘缓解期120例患儿，按随机分组原则分为观察组和对照组各60例。对照组予以沙美特罗替卡松粉吸入剂（舒利迭）治疗，早上及晚上各吸1次。观察组在对照组的基础上给予皮下免疫治疗，进行12个月疗程的治疗。对比两组患儿支气管哮喘发作次数以及临床控制率、肺功能变化。检测两组患儿血清Th1相关细胞因子[白细胞介素-2（IL-2）、γ干扰素（IFN-γ）]和Th2相关细胞因子[白细胞介素-4（IL-4）、白细胞介素-6（IL-6）]水平。结果：与治疗前相比，两组患儿治疗6月及治疗12个月后发作次数均显著降低（P＜0.05），且观察组患儿哮喘发作的次数低于对照组（P＜0.01）；治疗12个月后，观察组患儿的临床控制率显示为90%，显著高于对照组的66.67％（P＜0.05）。治疗6个月后、治疗12个月后，观察组患儿的第1 秒呼气流速（FEV1）占正常预计值百分比（FEV1%）及呼气峰流速（PEF）占正常预计值百分比（PEF%）均显著高于对照组（P＜0.01）；而与治疗6个月后相比，两组治疗12个月后上述2项指标均显著升高，且观察组明显高于对照组（P＜0.01）。治疗12个月后，两组患儿血清IL-2、IFN-γ水平均显著升高，且观察组明显高于对照组（P＜0.01）；而两组血清IL-4、IL-6水平均显著下降，且观察组明显低于对照组（P＜0.01）。结论：皮下免疫治疗联合沙美特罗替卡松粉（舒利迭）治疗中度支气管哮喘缓解期患儿的临床疗效确切，患儿支气管哮喘发作次数明显减少，肺功能改善明显，其作用机制可能与调节Th1/Th2相关细胞因子平衡有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy of subcutaneous immunotherapy combined with salmetroticasone powder inhalant in the treatment of children with moderate bronchial asthma in remission stage and the effects on the expression of serum Th1/Th2-related cytokines. Methods: A total of 120 children with moderate bronchial asthma in remission stage were selected from Foshan Maternal and Child Health Hospital of Southern Medical University from January 2020 to December 2020, according to the principle of random grouping, they were divided into observation group and control group, 60 cases each. The control group was treated with salmetroticasone powder inhalant (seretide), with once in the morning and once in the evening. The observation group was given subcutaneous immunotherapy on the basis of the control group for 12-month course of treatment. The frequency of bronchial asthma attacks, clinical control rate and pulmonary function changes were compared in the two groups of children. The levels of serum Th1-related cytokines [(interleukin-2 (IL-2), γ interferon (INF-γ)] and Th2-related cytokines [interleukin-4 (IL-4), interleukin-6 (IL-6)] were measured in both groups of children. Results: Compared with before treatment, the number of asthma attacks in the two groups were significantly reduced after 6 months and 12 months of treatment (P<0.05), and the number of asthma attacks in the observation group were lower than those in the control group (P<0.01). 12 months after treatment, the clinical control rate of the observation group was 90%,which was significantly higher than that 66.67% of the control group(P<0.05). At 6 months and 12 months after treatment, the percentage of normal expected value of forced expiratory volume in one second(FEV1%) and peak expiratory flow (PEF%) in the observation group were significantly higher than those in the control group (P<0.01), compared with 6 months after treatment, the above two indicators were significantly increased in the two groups after 12 months of treatment, and the observation group was significantly higher than the control group (P<0.01). At 12 months after treatment, serum levels of IL-2 and IFN-γ were significantly increased in both groups, and the observation group was significantly higher than the control group (P<0.01); serum levels of IL-4 and IL-6 in both groups were significantly decreased, and the observation group was significantly lower than the control group (P<0.01). Conclusion: The clinical efficacy of subcutaneous immunotherapy combined with salmeterol fluticasone powder (suletide) in treating children with moderate bronchial asthma in remission stage is definite. The number of bronchial asthma attacks in children is significantly reduced, and the pulmonary function is significantly improved. Its mechanism of action may be related to the regulation of Th 1/Th 2-related cytokines balance. |
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