布地奈德对rsv毛支患儿鼻咽分泌物中mcp-4 mdc水平的影响

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1、布地奈德对RSV毛支患儿鼻咽分泌物中MCP-4MDC水平的影响作者：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

2、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＞0.05）；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＜0.01），而MDC含量比较无显著性差异（P＞0.05）。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

3、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12【Abstract】ObjectiveToobservetheeffectofinhalationalglucocorticoids（budesonide）onRSVbronchiolitisandtheregulationofglucocorticoidsonMCP-4,MDCinNPS(nasopharyngealsecretions).MethodsNPSsampleswereobtainedfromRSVbronchiolitispatien

4、tsintheacuteandrehabiliationstage.Accordingtotheclinicalsymptoms，57samplesweredividedintomildbronchiolitisgroupandseverebronchiolitisgroup.Allthepatientshadnottakenanyglucocorticoidwithin2weeksbeforethehospitaladmission,andhalfofthemweretreatedbyglucocorticoi

5、d(budesonide)randomly.ELISAwasusedtodeterminetheconcentrationsofMCP-4,MDCinNPS.ResultsComparedwithcontrolgroup,intheacutephase,thelevelofMCP-4andMDCofNPSinglucocorticoidstreatinggroupweredecreaced,buttherewasnosignificantdifference(P>0.05).Intherestoration

6、stage,thelevelofMCP-4inglucocorticoidstreatinggroupweremarkedlylowerthanthoseincontrolgroup（P＜0.01）;thelevelofMDCinglucocorticoidstreatinggroupwerelowerthanthoseincontrolgroup,therewerenodifference(P>0.05).Notonlyintheacutephasebutintherestorationstage,the

7、clinicalevalutionscoresofRSVbronchiolitisinglucocorticoidstreatinggroupwerenotsignificantlylowerthanthoseofcontrolgroup.However,onthethirdday,the12clinicalevalutionscoresofRSVbronchiolitisinglucocorticoidstreatinggroupweresignificantlylowerthanthoseofcontrolg

8、roup.Inhalationalglucocorticoids（budesonide）onRSVbronchiolitiscan'tdecreasesignificantlythelengthofstayinthehospital.ConclusionsThebeneficialeffectofinhalationalglucocorticoidsonRSVbronch