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目的探讨治疗婴幼儿毛细支气管炎的方法,观察α-2b干扰素(r-IFNα-2b)、布地奈德和沙丁胺醇综合治疗婴幼儿毛细支气管炎的疗效。方法选择2003年1月~2006年1月收住院的136例毛细支气管患儿按1∶2的比例随机分为两组。对照组45例,采用常规治疗;观察组91例,在常规治疗的基础上加用α-2b干扰素肌注,布地奈德混悬液与沙丁胺醇雾化液氧气雾化吸入。用ELISA法分别检测血浆IgE、白介素-4(IL-4)、白介素-5(IL-5)、γ干扰素(γ-IFN),观察治疗前后IgE、IL-4、IL-5、γ-IFN的水平及临床症状、体征、住院时间。结果毛细支气管炎患儿血浆IL-4、IL-5、IgE水平在急性期(治疗前)明显升高,γ-IFN水平明显降低(P<0.01)。治疗后:观察组血浆IL-4、IL-5、IgE水平明显下降,γ-IFN水平较治疗前升高,差异均有统计学意义(P<0.01)。对照组血浆IL-4、IL-5、IgE水平较治疗前下降,γ-IFN水平较治疗前升高,但变化程度不如观察组明显,IL-4、IL-5、IgE水平高于正常组的水平,γ-IFN水平低于正常组的水平,差异有统计学意义(P<0.01)。在临床症状、体征及住院时间上,观察组明显优于对照组(P<0.01)。结论α-2b干扰素、布地奈德、沙丁胺醇综合治疗小儿毛细支气管炎可使患儿血中有关指标明显改善,缩短疗程。
Objective To investigate the method of treating bronchiolitis in infants and young children, and to observe the curative effect of bronchitis of infantile bronchiolitis treated by interferon alfa-2b (r-IFNα-2b), budesonide and salbutamol. Methods 136 cases of bronchiolitis admitted to hospital from January 2003 to January 2006 were randomly divided into two groups according to the ratio of 1: 2. The control group (n = 45) received routine treatment. The observation group (n = 91) received inhalation of budesonide suspension and salbutamol nebulized liquid oxygen inhalation on the basis of routine treatment with intramuscular injection of α-2b interferon. Serum levels of IgE, IL-4, IL-5 and γ-IFN were measured by ELISA. The levels of IgE, IL-4, IL- IFN levels and clinical symptoms, signs, length of stay. Results The levels of plasma IL-4, IL-5 and IgE in children with bronchiolitis were significantly increased in the acute phase (before treatment) and the level of γ-IFN was significantly decreased (P <0.01). After treatment, the levels of plasma IL-4, IL-5 and IgE in the observation group were significantly decreased, and the levels of γ-IFN were higher than those before treatment (all P <0.01). The level of IL-4, IL-5 and IgE in the control group decreased compared with that before treatment, and the level of γ-IFN was higher than that before treatment, but the level of IL-4, IL- Γ-IFN level was lower than that of the normal group (P <0.01). The clinical symptoms, signs and hospital stay, the observation group was significantly better than the control group (P <0.01). Conclusion α-2b interferon, budesonide, salbutamol comprehensive treatment of children with bronchiolitis can make the relevant indicators of blood in children significantly improved, shorten the course of treatment.