摘要
目的探讨小剂量依托红霉素对哮喘患儿痰液中性粒细胞(PMN)及血清白介素-8(IL-8)、白介素-17(IL-17)水平的影响。方法 2007年1月至2009年1月,24例非嗜酸粒细胞哮喘儿童随机分为依托红霉素组及非依托红霉素组,各12例。两组患儿均接受正规阶梯治疗,包括规律性吸入糖皮质激素和间断应用β2受体激动剂。依托红霉素组在此基础上加用依托红霉素3～5 mg/(kg.d)口服,4周。两组患儿在急性期和恢复期均进行诱导痰细胞分类检查,ELISA方法检测血清IL-8和IL-17浓度,并进行肺功能检查。结果两组患儿缓解期诱导痰中的PMN明显低于急性发作期,差异有统计学意义(P均<0.001)。依托红霉素组患儿缓解期的PMN明显低于非依托红霉素组,差异有统计学意义(P=0.001);两组患儿缓解期血清IL-8、IL-17浓度明显低于急性发作期,差异有统计学意义(P均<0.01),依托红霉素组缓解期患儿的血清IL-8、IL-17浓度低于非依托红霉素组缓解期,差异有统计学意义(P<0.01)。两组患儿缓解期的肺功能较急性发作期明显改善,差异有统计学意义(P<0.001);依托红霉素组的改善幅度(△PEFR%)优于对照组,差异有统计学意义(Z=3.349;P=0.001)。结论小剂量依托红霉素可明显改善以PMN浸润为主的气道炎症性哮喘,可能是治疗儿童哮喘的一种新方法。[临床儿科杂志,2012,30(5):431-434]
Objective To explore the effect of low-dose erythromycin estolate on sputum neutrophils（PMN） and serum levels of interleukin-8 and interleukin-17 in children with asthma.Methods From January 2007 to January 2009,24 children with asthma were randomly divided into non-erythromycin estolate group and erythromycin estolate group,twelve children for each group.Two groups of children received regular treatment including regular inhaled corticosteroids and intermittent inhaled β2 agonists,meanwhile erythromycin estolate group was taken orally erythromycin estolate 3-5 mg/（kg·d） for four weeks.During both of the acute and convalescent periods,cell sorting from induced sputum was processed,the serum concentrations of IL-8 and IL-17 were tested by ELISA and lung functions were detected in the two groups.Results In two groups,the PMN of induced sputum in convalescent period was significantly lower than that in acute period（P 0.001）.The PMN in convalescent period was significantly lower in erythromycin estolate group than that in non-erythromycin estolate group（P = 0.001）.The serum levels of IL-8 and IL-17 in two groups in convalescent period were significantly lower than those of during acute period（P 0.01）.The serum levels of IL-8 and IL-17 in erythromycin group were significantly lower than those in non-erythromycin estolate group during convalescent period（P 0.01）.The lung functions were improved significantly testing in two groups during convalescent period than those during acute time（P 0.001）,and the improvement rate（△PEFR%） in erythromycin estolate group was significantly greater than that in non-erythromycin estolate group（Z = 3.349;P = 0.001）.Conclusions Lowdose erythromycin estolate can significantly improve airway inflammation and lung function in children with asthma,thus may be a new way of treatment for asthma.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2012年第5期431-434,共4页
Journal of Clinical Pediatrics
基金
江苏省常州市科技发展计划基金项目(No.CS2007226)
关键词
哮喘
依托红霉素
诱导痰
中性粒细胞
儿童
asthma
erythromycin estolate
induced sputum
neutrophil
child
