细菌溶解产物联合维生素D在儿童哮喘合并反复呼吸道感染中的免疫调节作用及长期疗效观察OA
Observation of immunomodulatory effect and long-term efficacy of bacterial lysate combined with vitamin D in children with asthma complicated recurrent respiratory tract infections
目的:探究细菌溶解产物联合维生素D治疗儿童哮喘合并反复呼吸道感染(RRTIs)的长期效果及免疫调节作用.方法:选取2021年12月至2023年8月南阳市中心医院收治的哮喘合并RRTIs患儿220例,按随机数字表法分为对照组(110例,维生素D治疗)与观察组(110例,细菌溶解产物联合维生素D治疗,疗程3个月).比较两组临床疗效、安全性及治疗前后肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV1)、最大呼气流速(PEF)]、气道重塑[组织金属蛋白酶抑制因子-2(TIMP-2)、基质金属蛋白酶-2(MMP-2)、TGF-β1]、T细胞亚群(CD3+、CD4+、CD4+/CD8+)、Th17/Treg细胞因子(IL-6、IL-10、IL-17),随访1年观察长期效果.结果:观察组总有效率(92.73%)高于对照组总有效率(75.45%,P<0.05);观察组治疗后FVC、FEV1、PEF、CD3+T、CD4+T、CD4+T/CD8+T、IL-10水平高于对照组,血清TIMP-2、MMP-2、TGF-β1、IL-6、IL-17水平低于对照组(P<0.05);随访1年观察组呼吸道感染、哮喘发作次数、抗生素平均使用天数均少于对照组(P<0.05),两组不良反应发生率差异无统计学意义(P>0.05).结论:细菌溶解产物联合维生素D治疗儿童哮喘合并RRTIs疗效确切,可增强患儿免疫功能、调节Th17/Treg平衡,对改善肺功能、逆转气道重塑、避免病情反复具有积极作用.
Objective:To investigate long-term efficacy and immunomodulatory effects of bacterial lysate combined with vita-min D in treatment of asthma in children complicated with recurrent respiratory tract infections(RRTIs).Methods:Two hundred and twenty children with asthma combined with RRTIs were selected from December 2021 to August 2023 in Nanyang Central Hospital,and randomly assigned to control group(110 cases,treated with vitamin D)and observation group(110 cases,treated with bacterial lysate combined with vitamin D for a course of 3 months)using a random number table method.Clinical efficacy and safety were com-pared between two groups,as well as pulmonary function[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF)],airway remodeling[tissue inhibitor of metalloproteinase-2(TIMP-2),matrix metalloprotein-ase-2(MMP-2),TGF-β1],T cell subsets(CD3+,CD4+,CD4+/CD8+),and Th17/Treg cell cytokines(IL-6,IL-10,IL-17)before and after treatment.Long-term effects were observed through a one-year follow-up.Results:Total effective rate in observation group was 92.73%,which was higher than control group(75.45%)(P<0.05).After treatment,levels of FVC,FEV1,PEF,CD3+T,CD4+T,CD4+T/CD8+T and IL-10 in observation group were higher than control group,while levels of serum TIMP-2,MMP-2,TGF-β1,IL-6 and IL-17 were lower than control group(P<0.05).During a 1-year follow-up,observation group had fewer respiratory tract infec-tions,asthma attacks and average days of antibiotic use than control group(P<0.05).There was no significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion:Treatment of bacterial lysate combined with vitamin D for children with asthma complicated RRTIs has a definite therapeutic effect,which can enhance immune function of children,regulate balance of Th17/Treg,and play a positive role in improving lung function,reversing airway remodeling,and avoiding disease recurrence.
刘阳;王艺;张映雪;曾苑;白方会
南阳市中心医院儿童神经内科病区,南阳 473000南阳市中心医院儿童消化心血管区,南阳 473000南阳市中心医院儿童神经内科病区,南阳 473000南阳市中心医院儿童神经内科病区,南阳 473000南阳市中心医院医务科,南阳 473000
医药卫生
哮喘反复呼吸道感染细菌溶解产物维生素D免疫长期效果
AsthmaRecurrent respiratory tract infectionsBacterial lysateVitamin DImmunityLong-term effect
《中国免疫学杂志》 2026 (3)
555-559,5
河南省二〇二三年科技发展计划项目(232102310198).
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