雾化重组人干扰素α1b联合热毒宁对3～8岁儿童呼吸道合胞病毒感染肺炎的免疫学分析
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摘要
目的研究雾化重组人干扰素α1b联合热毒宁对3～8岁儿童呼吸道合胞病毒感染所致肺炎的免疫学疗效。方法选取2016年1月至2018年1月接收治疗的3～8岁儿童呼吸道合胞病毒感染所致肺炎的患儿70例作为研究对象。采用随机数字表法将其随机分为A组(重组人干扰素α1b雾化治疗)和B组(重组人干扰素α1b雾化+热毒宁治疗),每组35例。观察2组患儿基线资料、血液免疫学指标、呼出气炎性因子表达、住院指标和不良反应发生情况。结果 B组患儿治疗有效率(91.43%)显著高于A组(71.43%),差异有统计学意义(Z=13.652,P=0.000)。治疗后比较,B组患儿CD~+_3、CD~+_4、CD~+_8和B细胞数改善程度均显著优于A组,差异有统计学意义(P<0.05)。2组患儿治疗后各项炎性因子在呼出气中表达量均显著下降,但B组患儿治疗后IL-1、IL-6、TNF-α和NF-κB的表达量均显著低于A组,差异有统计学意义(P<0.05)。B组患儿住院花销、治疗疗程、住院时间和症状消失时间均显著少于A组,差异有统计学意义(P<0.05)。2组患儿治疗过程中均无严重不良反应发生,且不良反应发生率比较,差异无统计学意义(χ~2=3.188,P=0.074)。结论雾化重组人干扰素α1b联合热毒宁对3～8岁儿童呼吸道合胞病毒感染所致肺炎的疗效较佳,能够显著改善免疫学指标,降低呼出气炎性因子表达,改善住院指标,安全可靠。
Objective To investigate the immunological effects of atomization recombinant human interferon α1 b combined with Reduning on pneumonia caused by respiratory syncytial virus infection in 3～8 years children.Methods Seventy children with pneumonia caused by respiratory syncytial virus infection in children aged 3～8 years who were treated from January 2016 to January 2018 were enrolled in the study,who were randomly divided into groupsA(recombinant human interferon α1 b atomization treatment) and group B(recombinant human interferon α1 b atomization +Reduning injection),with 35 cases in each group.The baseline data,blood immunological indexes,the expression levels of exhaled inflammatory factors,hospitalization indexes and the incidence rate of adverse reactions were observed and compared between the two groups.Results The effective rate in group B was 91.43%,which was significantly higher than that(71.43%) in group A(P<0.01).After treatment,the improvement degree of CD~+_3,CD~+_4,CD~+_8 and B cell counts in group B was significantly better than that in group A(P<0.05).The expression levels of inflammatory factors in exhaled breath were significantly decreased after treatment in both groups,moreover, the expression levels of IL-1,IL-6,TNF-α and NF-κB in group B were significantly lower than those in group A(P<0.05). The hospitalization expenses,treatment course,hospitalization time and symptom disappearance time in group B were significantly less than those in group A(P<0.05).In addition no severe adverse reactions were found during treatment in both groups,there was no significant diference between the two groups(P>0.05).Conclusion The atomization recombinant human interferon α1 b combined with Reduning is effective in treatment of pneumonia caused by respiratory syncytial virus infection in children aged 3～8 years,which can significantly improve immunological indexes,reduce the expression levels of exhaled inflammatory factors,improve hospitalization indexes,with safety and reliability.
Objective To investigate the immunological effects of atomization recombinant human interferon α1 b combined with Reduning on pneumonia caused by respiratory syncytial virus infection in 3～8 years children.Methods Seventy children with pneumonia caused by respiratory syncytial virus infection in children aged 3～8 years who were treated from January 2016 to January 2018 were enrolled in the study,who were randomly divided into groupsA(recombinant human interferon α1 b atomization treatment) and group B(recombinant human interferon α1 b atomization +Reduning injection),with 35 cases in each group.The baseline data,blood immunological indexes,the expression levels of exhaled inflammatory factors,hospitalization indexes and the incidence rate of adverse reactions were observed and compared between the two groups.Results The effective rate in group B was 91.43%,which was significantly higher than that(71.43%) in group A(P<0.01).After treatment,the improvement degree of CD~+_3,CD~+_4,CD~+_8 and B cell counts in group B was significantly better than that in group A(P<0.05).The expression levels of inflammatory factors in exhaled breath were significantly decreased after treatment in both groups,moreover, the expression levels of IL-1,IL-6,TNF-α and NF-κB in group B were significantly lower than those in group A(P<0.05). The hospitalization expenses,treatment course,hospitalization time and symptom disappearance time in group B were significantly less than those in group A(P<0.05).In addition no severe adverse reactions were found during treatment in both groups,there was no significant diference between the two groups(P>0.05).Conclusion The atomization recombinant human interferon α1 b combined with Reduning is effective in treatment of pneumonia caused by respiratory syncytial virus infection in children aged 3～8 years,which can significantly improve immunological indexes,reduce the expression levels of exhaled inflammatory factors,improve hospitalization indexes,with safety and reliability.
引文
1 Bont L,Checchia PA,Fauroux B,et al.Defining the Epidemiology and Burden of Severe Respiratory Syncytial Virus Infection Among Infants and Children in Western Countries.Infectious Diseases & Therapy,2016,5:271-298.
2 Taylor S,Taylor RJ,Lustig RL,et al.Modelling estimates of the burden of respiratory syncytial virus infection in children in the UK.Bmj Open,2016,6:e009337.
3 Wa DSP,Heinonen S,Hasrat R,et al.Nasopharyngeal Microbiota,Host Transcriptome,and Disease Severity in Children with Respiratory Syncytial Virus Infection.Am J Respir Crit Care Med,2016,194:1104-1115.
4 陈必全,孙子发,李阳,等.热毒宁与干扰素联合治疗手足口病患儿的临床疗效.中华医院感染学杂志,2016,26:2143-2145.
5 Navai N,Benedict W,Zhang G,et al.Phase 1b Trial to Evaluate Tissue Response to a Second Dose of Intravesical Recombinant Adenoviral Interferon α2b Formulated in Syn3 for Failures of Bacillus Calmette–Guerin(BCG) Therapy in Nonmuscle Invasive Bladder Cancer.Annals of Surgical Oncology,2016,23:4110-4114.
6 诸福棠主编.实用儿科学.第7版.北京:人民卫生出版社,2015.1047.
7 康利娜,成芳,安红,等.雾化吸入重组人干扰素α1b治疗小儿毛细支气管炎的临床观察.中国药房,2016:758-760.
8 葛雯,李海波,于洋,等.热毒宁注射液化学成分研究(Ⅳ).中草药,2017,48:1643-1649.
9 黄艳娴.rhIFN-α1b对RSV感染鼠肺病变及JAK/STAT和TLR4/NF-κB信号通路的影响.第四军医大学,2015.
10 雾化吸入重组人干扰素α1b对RSV感染鼠T淋巴细胞亚群的影响// 全国儿科感染性疾病学术会议.2013.
11 刘瑞清,张国成,黄可飞,等.重组人干扰素α1b对呼吸道合胞病毒感染小鼠外周血T淋巴细胞亚群及肺组织病理学的影响.现代生物医学进展,2013,13:1639-1644.
12 刘永兰,杨红娟,李国胜.热毒宁注射液的临床疗效评价.山西医药杂志,2017,46:2584-2588.
13 张美玲,李峰,刘雯,等.中药金银花抗病毒作用研究进展.辽宁中医药大学学报,2016,18:156-158.
14 王意忠,崔晓兰,高英杰,等.栀子提取物抗病毒试验研究.中国中药杂志,2006,31:1176-1178.
15 刘守祥,骆小航.热毒宁注射液治疗病毒性上呼吸道感染临床疗效分析.深圳中西医结合杂志,2017,27:27-28.
16 唐光伟.小儿呼吸道病毒感染的观察及热毒宁治疗效果评定.中国卫生标准管理,2017,8:117-118.
2 Taylor S,Taylor RJ,Lustig RL,et al.Modelling estimates of the burden of respiratory syncytial virus infection in children in the UK.Bmj Open,2016,6:e009337.
3 Wa DSP,Heinonen S,Hasrat R,et al.Nasopharyngeal Microbiota,Host Transcriptome,and Disease Severity in Children with Respiratory Syncytial Virus Infection.Am J Respir Crit Care Med,2016,194:1104-1115.
4 陈必全,孙子发,李阳,等.热毒宁与干扰素联合治疗手足口病患儿的临床疗效.中华医院感染学杂志,2016,26:2143-2145.
5 Navai N,Benedict W,Zhang G,et al.Phase 1b Trial to Evaluate Tissue Response to a Second Dose of Intravesical Recombinant Adenoviral Interferon α2b Formulated in Syn3 for Failures of Bacillus Calmette–Guerin(BCG) Therapy in Nonmuscle Invasive Bladder Cancer.Annals of Surgical Oncology,2016,23:4110-4114.
6 诸福棠主编.实用儿科学.第7版.北京:人民卫生出版社,2015.1047.
7 康利娜,成芳,安红,等.雾化吸入重组人干扰素α1b治疗小儿毛细支气管炎的临床观察.中国药房,2016:758-760.
8 葛雯,李海波,于洋,等.热毒宁注射液化学成分研究(Ⅳ).中草药,2017,48:1643-1649.
9 黄艳娴.rhIFN-α1b对RSV感染鼠肺病变及JAK/STAT和TLR4/NF-κB信号通路的影响.第四军医大学,2015.
10 雾化吸入重组人干扰素α1b对RSV感染鼠T淋巴细胞亚群的影响// 全国儿科感染性疾病学术会议.2013.
11 刘瑞清,张国成,黄可飞,等.重组人干扰素α1b对呼吸道合胞病毒感染小鼠外周血T淋巴细胞亚群及肺组织病理学的影响.现代生物医学进展,2013,13:1639-1644.
12 刘永兰,杨红娟,李国胜.热毒宁注射液的临床疗效评价.山西医药杂志,2017,46:2584-2588.
13 张美玲,李峰,刘雯,等.中药金银花抗病毒作用研究进展.辽宁中医药大学学报,2016,18:156-158.
14 王意忠,崔晓兰,高英杰,等.栀子提取物抗病毒试验研究.中国中药杂志,2006,31:1176-1178.
15 刘守祥,骆小航.热毒宁注射液治疗病毒性上呼吸道感染临床疗效分析.深圳中西医结合杂志,2017,27:27-28.
16 唐光伟.小儿呼吸道病毒感染的观察及热毒宁治疗效果评定.中国卫生标准管理,2017,8:117-118.
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