CAJ | 학술논문

目的观察和分析布地奈德治疗儿童呼吸道合胞病毒（ RSV）感染相关喘息的疗效及其对血清炎症介质水平的影响。方法选取200例RSV感染相关首次喘息发作的患儿，随机分为观察组和对照组，每组100例。两组患儿均给予基础对症治疗，对照组患儿在此基础上应用万托林雾化液吸入治疗，观察组患儿在对照组疗法基础上联合应用布地奈德混悬液吸入治疗。对两组患儿的呼吸改善时间、喘息缓解时间和住院时间以及治疗前后血清白细胞介素-4（IL-4）、IL-6、IL-12、C反应蛋白（CRP）、IgE水平和外周血T淋巴细胞亚群情况进行观察和检测，并对患儿出院后6个月和1年内的喘息发作情况和发生哮喘情况进行随访和观察。结果观察组患儿的呼吸改善时间、喘息改善时间、住院时间均显著短于对照组（ P＜0.05）；治疗后，两组患儿的血清IL-4、IL-6、CRP、IgE水平和CD8＋T细胞比例较治疗前显著下降（ P＜0.05），而血清IL-12水平和CD3＋T细胞比例、CD4＋T细胞比例、CD4＋/CD8＋T细胞比值较治疗前显著上升（ P＜0.05），且观察组患者上述指标的变化幅度显著大于对照组（P＜0.05）；观察组患儿于出院6个月内和1年内喘息发作的比例均显著低于对照组（P＜0.05）。结论应用布地奈德治疗儿童RSV感染相关喘息的疗效显著，可更快速地缓解患儿症状，显著改善患儿炎症介质水平，降低喘息复发几率。
목적관찰화분석포지내덕치료인동호흡도합포병독（ RSV）감염상관천식적료효급기대혈청염증개질수평적영향。방법선취200례RSV감염상관수차천식발작적환인，수궤분위관찰조화대조조，매조100례。량조환인균급여기출대증치료，대조조환인재차기출상응용만탁림무화액흡입치료，관찰조환인재대조조요법기출상연합응용포지내덕혼현액흡입치료。대량조환인적호흡개선시간、천식완해시간화주원시간이급치료전후혈청백세포개소-4（IL-4）、IL-6、IL-12、C반응단백（CRP）、IgE수평화외주혈T림파세포아군정황진행관찰화검측，병대환인출원후6개월화1년내적천식발작정황화발생효천정황진행수방화관찰。결과관찰조환인적호흡개선시간、천식개선시간、주원시간균현저단우대조조（ P＜0.05）；치료후，량조환인적혈청IL-4、IL-6、CRP、IgE수평화CD8＋T세포비례교치료전현저하강（ P＜0.05），이혈청IL-12수평화CD3＋T세포비례、CD4＋T세포비례、CD4＋/CD8＋T세포비치교치료전현저상승（ P＜0.05），차관찰조환자상술지표적변화폭도현저대우대조조（P＜0.05）；관찰조환인우출원6개월내화1년내천식발작적비례균현저저우대조조（P＜0.05）。결론응용포지내덕치료인동RSV감염상관천식적료효현저，가경쾌속지완해환인증상，현저개선환인염증개질수평，강저천식복발궤솔。
Objective To observe and analyze the curative effects of budesonide treatment for the children with respiratory syncytial virus ( RSV) infection associated wheezing and its influence on the serum inflammatory me-diators levels.Methods 200 patients with the first RSV infection associated wheezing were selected and randomly di-vided into observation group and control group.All the patients in the two groups were treated with the basic treatment. Control group ( n=100) was added with liquid aerosol ventolin inhalation treatment,while the observation group ( n=100 ) was treated with budesonide inhalation treatment on the basis of control group.The respiratory improvement time, wheezing remission time, hospitalization time and the serum interleukin-4 ( IL-4), IL-6, IL-12, C reactive protein ( CRP) ,IgE levels and T lymphocytes subsets in the peripheral blood of the children in the two groups were observed and detected before and after treatment.Meanwhile,the patients were followed-up and the wheezing recurrence rates, asthma occurrence in 6 months and 1 year after the discharged day were observed.Results The respiratory improve-ment time,wheezing remission time and the hospitalization time of observation group were significantly shorter than those of control group (P<0.05).After treatment,the serum IL-4,IL-6,CRP,IgE levels and CD8 +T lymphocyte pro-portion of the two groups decreased significantly (P<0.05),while the serum IL-12 level,CD3 +T lymphocyte propor-tion,CD4 +T lymphocyte proportion,the ratio of CD4 +/CD8 +T lymphocyte increased significantly (P <0.05),and there were significant differences in the above indexes between the 2 groups ( P<0.05 ) .The wheezing recurrence rati-os in the 6 months and 1 year after the discharged day of observation group were significantly lower than those of con-trol group ( P<0.05 ) .Conclusion The curative effects of budesonide in the treatment of the children with RSV in-fection associated wheezing is significant.The therapy can alleviate the symptoms more quickly,improve the levels of inflammatory mediators and reduce the occurrence of recurrence.