不同剂量布地奈德联合西替利嗪对支气管哮喘急性发作患儿Th17/Treg免疫平衡的影响OA
Effects of Different Doses of Budesonide Combined with Cetirizine on the Th17/Treg Immune Balance in Children with Acute Exacerbation of Bronchial Asthma
目的:探讨不同剂量布地奈德联合西替利嗪治疗支气管哮喘急性发作患儿的疗效及对外周血辅助性 T 细胞17(Th17)/调节性 T 细胞(Treg)免疫平衡的影响.方法:前瞻性选取 2022 年 3 月～2024年1月本院收治的 96 例支气管哮喘急性发作患儿作为研究对象,按照随机数字表法分为对照组和观察组,每组48例.两组均口服盐酸西替利嗪片,在此基础上对照组每次雾化吸入0.5 mg吸入用布地奈德混悬液,观察组每次雾化吸入1.0 mg 吸入用布地奈德混悬液.比较两组患儿外周血 Th17与Treg 细胞水平及比值、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]、炎症因子[白介素-6(IL-6)、白介素-10(IL-10)、白介素-17(IL-17)、转化生长因子-β(TGF-β)]水平、临床疗效及不良反应发生情况.结果:治疗后,两组患儿 Treg、FEV1、FVC、FEV1/FVC、IL-10 和 TGF-β均升高,且观察组高于对照组(P＜0.05);Th17、Th17/Treg、IL-6 和 IL-17 均降低,且观察组低于对照组(P＜0.05).观察组治疗总有效率(95.83%)高于对照组(83.33%,P＜0.05).治疗期间,两组不良反应总发生率比较无统计学差异(P＞0.05).结论:相较雾化吸入 0.5 mg 布地奈德,雾化吸入1.0 mg布地奈德联合西替利嗪治疗支气管哮喘急性发作患儿,能显著提高临床疗效,更有效地调节 Th17/Treg 免疫平衡,改善肺功能及减轻炎症反应,且未增加不良反应发生风险.
Objective:To explore the efficacy of different doses of budesonide combined with cetirizine in the treatment of children with acute exacerbation of bronchial asthma,and its effect on the balance of peripheral blood helper T cell 17(Th17)/regulatory T cell(Treg)immune.Methods:A total of 96 children with acute exacerbation of bronchial asthma admitted to our hospital from March 2022 to January 2024 were prospectively enrolled and divided into control group and observation group by random number table,with 48 cases in each group.Both groups were orally administered cetirizine hydrochloride tablets.On this basis,the control group received 0.5 mg of inhaled budesonide suspension by nebulization each time.while the observation group received 1.0 mg of inhaled budesonide suspension by nebulization each time.Peripheral blood Treg and Th17 cell levels and their ratio,lung function indicators including forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and FEV1/FVC,inflammatory factors including interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17(IL-17)and transforming growth factor-β(TGF-β),as well as clinical efficacy and incidence of adverse reactions were compared between the two groups.Results:After treatment,Treg,FEV1,FVC,FEV1/FVC,IL-10 and TGF-β were increased in both groups,and were higher in the observation group(P<0.05);Th17,Th17/Treg,IL-6 and IL-17 were decreased in both groups,and were lower in the observation group(P<0.05).The total effective rate of the observation group was 95.83%,which was higher than 83.33%of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with the inhalation of 0.5 mg budesonide,the combined inhalation of 1.0 mg budesonide and cetirizine in the treatment of children with acute bronchial asthma can significantly improve the clinical efficacy.regulate Th17/Treg immune balance,improve lung function and alleviate inflammatory response in children with acute exacerbation of bronchial asthma,without obviously increasing the risk of adverse reactions.
陈洋洋;马鸿琦;吴宗跃
南阳市中心医院,南阳 473000南阳医学高等专科学校护理系,南阳 473000南阳市中心医院,南阳 473000
医药卫生
布地奈德西替利嗪支气管哮喘辅助性T细胞17/调节性T细胞免疫调节临床疗效
budesonidecetirizinebronchial asthmahelper T cell 17/regulatory T cellimmune regulationclinical efficacy
《中国合理用药探索》 2026 (5)
38-43,6
河南省医学科技攻关计划项目(LHGJ20211022)
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