【摘要】 【目的】探讨免疫调节剂对哮喘儿童血清Th1/Th2细胞因子的影响及临床疗效。【方法】选择哮喘急性发作期儿童患者45例,分为两组:治疗组29例,服泛福舒(BV)。对照组16例,给予相对应级别剂量的糖皮质激素吸入治疗。入选患儿随访1年。所有患儿在治疗前及12个月后检测血清IL-4、IFN-γ、血浆总IgE浓度,测定肺功能。【结果】治疗组因哮喘发作需急诊就诊的次数为(1.02±0.92)次,呼吸道感染的次数(1.32±1.03)次,而对照组分别为(2.17±1.52)和(3.78±1.81)次,两组差异有统计学意义(P<0.05);两组患儿呼吸道感染频率和哮喘再发次数正相关(P<0.01)。治疗后,两组IgE水平无明显下降。治疗组血清IL-4水平无明显改变,IFN-γ水平明显升高,对照组血清IL-4水平下降,IFN-γ水平升高;两组IFN-γ/IL-4比值较治疗前均明显升高,差异有统计学意义(P<0.05);两组组间比较:治疗前后,两组IFN-γ/IL-4比值比较,差异无统计学意义(P>0.05)。治疗后治疗组患儿肺功能指标明显优于对照组(P<0.05)。【结论】BV不仅增强呼吸道特异性及非特异性的免疫防御功能,降低诱发哮喘发作的危险因素;而且能够纠正机体Th1/Th2类细胞表达的偏移,调整哮喘患儿的免疫异常。更多还原

【Abstract】 【Objective】 To investigate the effect and clinical efficacy of immunomodulator on serum Th1 / Th2 cytokines in asthmatic children. 【Methods】 Forty-five children of asthma at acute stage were enrolled and divided into two groups. Twenty-nine cases took bacterial lysates (Broncho-Vaxom, BV) in treatment group / BV group. Sixteen cases were given the same amount of inhaled corticosteroids (ICS) for treatment in control group / ICS group. Blood samples of all patients were drawn before and 12 months after treatment to detect the serum IL-4 and IFN-γ and total plasma IgE levels, and their lung functions were measured as well. All of them were followed up for one year. 【Results】 The frequencies of emergency visiting for asthma attack and respiratory tract infection in treatment group were (1.32 ± 1.03) and (1.32 ± 1.03) respectively, while in control group the frequencies were (2.17 ± 1.52) and (3.78 ± 1.81) respectively. The differences between the two groups had statistical significance (P < 0.05). The frequencies of respiratory tract infection were positively correlated with that of asthma relapse in both groups (P < 0.01). IgE levels did not decrease obviously in both groups after treatment. Serum level of IL-4 did not change but IFN-γ increased obviously in treatment group. In control group, serum level of IL-4 decreased and IFN-γ increased. The ratios of IFN-γ / IL-4 in both groups increased obviously compared with that before treatment and the differences had statistical significance (P < 0.05). The ratios of IFN-γ / IL-4 before and after treatment in both groups had no statistical significances (P > 0.05). The lung function index in treatment group was better than that in control group (P < 0.05). 【Conclusions】 Broncho-Vaxom not only enhances the specific and non-specific immune defense function of respiratory tract, reduces the risk factors of inducing asthma, corrects the expression migration of Th1/Th2 type cytokines, but also regulates the immune abnormality of asthmatic children.更多还原