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目的观察雾化吸入布地奈德对呼吸道合胞病毒(RSV)毛细支气管炎(毛支)患儿的治疗效果和对鼻咽分泌物(NPS)中MCP-4、MDC水平的影响,探讨布地奈德治疗RSV毛细支气管炎的机制。方法收集RSV检测阳性的毛支住院患儿57例,分成布地奈德雾化吸入组(激素组29例)和非激素组(28例)。急性期、恢复期分别抽取NPS,采用酶联免疫吸附法测定RSV毛支患儿NPS中MCP-4、MDC水平。结果在急性期,RSV毛支患儿激素组NPS中MCP-4、MDC含量与非激素组比较均有下降,但无显著性差异(P均>0.05);恢复期激素组NPS中MCP-4含量与非激素组比较有显著下降(P<0.01),而MDC含量比较无显著性差异(P>0.05)。雾化吸入布地奈德可以改善RSV毛支患儿临床症状,但不能缩短住院时间。在急性期,中、重度患儿组NPS中MCP-4、MDC含量均显著高于轻度组。结论布地奈德雾化吸入能明显改善RSV毛支患儿的症状,其治疗作用可能与减少NPS中MCP-4水平有关。NPS中的MCP-4、MDC水平可反映毛支的病情严重程度。
Objective To observe the therapeutic effects of inhaled budesonide on children with respiratory syncytial virus (RSV) bronchiolitis (bronchiolitis) and on the levels of MCP-4 and MDC in nasopharyngeal secretions (NPS) German treatment of RSV bronchiolitis mechanism. Methods Fifty-seven pediatric patients with capillary branch syndrome were enrolled in this study. They were divided into budesonide inhalation group (29 cases in hormone group) and non-hormone group (28 cases). Acute and convalescent NPS were separately extracted, and MCP-4 and MDC levels in NPS of children with RSV bronchiolitis were detected by enzyme-linked immunosorbent assay. Results During the acute phase, the levels of MCP-4 and MDC in NPS of hormone-treated children with RSV bronchiolitis decreased compared with non-hormone group, but there was no significant difference (all P> 0.05) (P <0.01), while the content of MDC had no significant difference (P> 0.05). Inhaled budesonide can improve the clinical symptoms of children with RSV bronchiolitis, but can not shorten the hospital stay. MCP-4 and MDC contents in NPS of acute, moderate and severe cases were significantly higher than those in mild group. Conclusion Budesonide inhalation can significantly improve the symptoms of children with RSV bronchiolitis, the therapeutic effect may be related to the reduction of MCP-4 in NPS. MCP-4 in NPS, MDC level can reflect the severity of the branch of the disease.