文档介绍：布地奈德对RSV毛支患儿鼻咽分泌物中MCP
作者:陈福将李昌崇罗运春
【摘要】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>);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<),而MDC含量比较无显著性差异(P>)。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。
【关键词】 RSV毛细支气管炎糖皮质激素单核细胞趋化蛋白4 巨噬细胞衍生趋化因子
【Abstract】 Objective To observe the effect of inhalational glucocorticoids(budesonide)on RSV bronchiolitis and the regulation of glucocorticoids on MCP-4, MDC in NPS (nasopharyngeal secretions). Methods NPS samples RSV bronchiolitis patients in the acute and rehabiliation stage. According to the clinical symptoms,57 samples ild bronchiolitis group and severe bronchiolitis group. All the patients had not taken any glucocorticoid ission,and half of them ly. ELISA ine the concentrations of MCP-4, MDC in NPS. Results pared arkedly loay be at least in part due to thEir direct inhibitory effect on MCP-4 generation. Level of MCP-4 and MDC can reflect the severity of RSV Bronchiolitis.
【Key an等[7]提出的标准,根据呼吸次数、哮鸣音、发绀情况及辅助呼吸肌参与4项临床评分,≤6分为轻度;7~9分为中度;10~11分为重度,理论最高分为12分。分为轻、中、重度。57例患儿随机分成两组,即激素组和非激素组,非激素组常规给予病毒唑,沐舒坦雾化吸入,气道阻塞严重者给予吸痰和氧疗。激素组入院后即加用普