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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (03): 298 -304. doi: 10.3877/cma.j.issn.1673-5250.2021.03.010

Original Article

Clinical efficacy of budesonide combined with recombinant human interferon α-1b in the treatment of acute infantile bronchiolitis

Yu Ge, Jianmu Li†(), Lingling Feng, Fan Yang   

  • Received:2020-11-18 Revised:2021-04-27 Published:2021-06-01
  • Corresponding author: Jianmu Li
  • Supported by:
    Scientific Research Project of Hubei Health and Family Planning Commission(WJ2017F127)
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Objective

To explore clinical efficacy of budesonide combined with recombinant human interferon (rhIFN)α-1b in the treatment of acute infantile bronchiolitis (AIB).

Methods

From January 2017 to January 2019, a total of 174 AIB children admitted to Xiantao First People′s Hospital Affiliated to Yangtze University were selected into this study. By radom number table method, they were divided into observation group (n=87, aerosol inhalation therapy by rhIFNα-1b combined with budesonide) and control group (n=87, aerosol inhalation therapy only by budesonide). The general clinical data, total effective rate, disappearance time of main symptoms(cough, wheeze, pant), levels of T lymphocyte subsets (CD4+ , CD8+ , CD4+ /CD8+ ), immunoglobulins (Ig)G, IgA, IgM, serum interleukin (IL)-4, -6 and tumor necrosis factor (TNF)-α levels before and after treatment were compared between two groups. The procedures followed in this study conformed to the ethical standards formulated by the Ethics Committee of cases collection hospital, which has been approved by the Ethics Committee (Approval No.XTYYLW2021036), and informed consent was obtained form guardians of all children.

Results

①There were no significant differences between two groups in general clinical data such as gender constituent ratio, age, course of diseases and breast feeding rate (P>0.05). ②The total curative effective rate in observation group (95.4%, 83/87) was significantly higher than that in control group (81.6%, 71/87), and the difference was statistically significant (χ2=8.135, P=0.004). ③The disappearance time and rale of cough, wheeze, pant in observation group were shorter or lower than those in control group, and the difference between two groups were statistically significant (P<0.05). ④After treatment, levels of serum CD4+ , CD8+ and CD4+ /CD8+ between two groups, the differences were statistically significant (P<0.05). However, after treatment , only levels of serum CD8+ in observation group and control group were lower than those before treatment, respectively, and the other levels of CD4+ and CD4+ /CD8+ were higher than those before treatment, respectively, and the differences were also statistically significant (P<0.05). ⑤After treatment, levels of serum IgG, IgA and IgM in observation group were higher than those in control group, respectively, and the differences were statistically significant (P<0.05). However, comparison within groups, levels of serum IgG, IgA and IgM in observation group and control group after treatment were higher than those before treatment, respectively, and the differences were also statistically significant (P<0.05). ⑥After treatment, levels of serum IL-4, -8 and TNF-α in two groups were lower than those in control group, respectively, and the differences between two groups were statistically significant (P<0.05). However, comparison within groups, levels of serum IL-4, IL-8 and TNF-α in observation group and control group after treatment were lower than those before treatment, respectively, and the differences were statistically significant (P<0.05).

Conclusions

Aerosol inhalation therapy by budesonide combined with rhIFNα-1b has a significant clinical effect in treatment of AIB, which can improve children′s clinical symptoms and immune function, and reduce inflammatory response.

Key words: Budesonide, Interferon alfa-1b, Acute infantile bronchiolitis, Immunity, T-lymphocytes, Child
表1 2组AIB小儿毛细支气管炎患儿一般临床资料比较
组别 例数 性别[例数(%)] 年龄(月，±s) 病程(d，±s) 母乳喂养[例数(%)]
男 女
观察组 87 48(55.2) 39(44.8) 12.2±2.5 6.1±1.1 65(74.7)
对照组 87 50(57.5) 37(42.5) 12.2±3.3 6.0±1.1 67(77.0)
检验值   χ2＝0.093 t＝0.156 t＝0.298 χ2＝0.126  
P值   0.764 0.876 0.766 0.723  
表2 2组AIB患儿治疗有效率比较[例数(%)]
组别 例数 显效 有效 无效 总有效率
观察组 87 53(60.9) 30(34.5) 4(4.6) 83(95.4)
对照组 87 44(50.6) 27(31.0) 16(18.4) 71(81.6)
χ2值   - - - 8.135
P值   - - - 0.004
表3 2组AIB患儿临床症状消失时间比较(d，±s)
组别 例数 咳嗽 喘息 气促 啰音
观察组 87 6.0±1.1 4.1±1.2 4.3±1.3 4.1±1.1
对照组 87 8.0±2.2 6.2±1.5 6.4±1.5 5.7±1.3
t值   7.534 9.918 10.040 8.940
P值   <0.001 <0.001 <0.001 <0.001
表4 2组AIB患儿治疗前、后外周血T淋巴细胞亚群水平比较(%，±s)
组别 例数 CD4+ CD8+ CD4+/CD8+
治疗前 治疗后 t值 P值 治疗前 治疗后 t值 P值 治疗前 治疗后 t值 P值
观察组 87 39.4±4.2 48.4±5.0 12.973 <0.001 35.9±3.4 25.7±3.1 20.764 <0.001 1.1±0.2 1.7±0.2 18.587 <0.001
对照组 87 39.1±4.4 41.4±5.3 3.038 0.003 35.7±3.2 31.1±2.3 10.921 <0.001 1.1±0.2 1.3±0.2 6.097 <0.001
t值   0.351 9.091     0.501 12.986     0.321 12.493    
P值   0.726 <0.001     0.618 <0.001 0.749 <0.001    
表5 2组AIB患儿治疗前、后血清IgG、IgA、IgM水平比较(g/L，±s)
组别 例数 IgG IgA IgM
治疗前 治疗后 t值 P值 治疗前 治疗后 t值 P值 治疗前 治疗后 t值 P值
观察组 87 7.9±0.9 12.0±1.5 21.374 <0.001 1.03±0.18 1.35±0.22 10.501 <0.001 1.04±0.12 1.73±0.17 30.929 <0.001
对照组 87 7.9±0.9 9.3±1.2 8.771 <0.001 1.01±0.14 1.17±0.12 8.094 <0.001 1.07±0.14 1.29±0.22 7.869 <0.001
t值   0.221 12.733     0.818 6.701     1.518 14.761    
P值   0.826 <0.001     0.415 <0.001     0.131 <0.001    
表6 2组AIB患儿治疗前、后血清IL-4、-8及TNF-α水平比较(pg/mL，±s)
组别 例数 IL-4 IL-8 TNF-α
治疗前 治疗后 t值 P值 治疗前 治疗后 t值 P值 治疗前 治疗后 t值 P值
观察组 87 52.3±9.8 32.3±8.4 14.431 <0.001 62.0±13.3 28.9±9.7 18.744 <0.001 191.2±31.4 127.9±10.8 17.757 <0.001
对照组 87 52.2±9.9 40.3±8.1 8.616 <0.001 61.3±12.2 41.6±9.3 11.984 <0.001 188.5±29.6 155.8±21.4 8.356 <0.001
t值   0.106 6.391     0.341 8.796     0.581 10.852    
P值   0.915 <0.001     0.733 <0.001     0.562 <0.001    
[3]
van Miert C, Fernandes RM, Eccleson H, et al. Non-invasive ventilation for the management of children with bronchiolitis (NOVEMBR): a feasibility study and core outcome set development protocol[J]. Trials, 2018, 19(1): 627. DOI: 10.1186/s13063-018-2969-9.
[4]
Jaszczoft S, Polewczyk T, Dofęga-Kozierowska M, et al. Comparison of lung ultrasound and chest X-ray findings in children with bronchiolitis[J]. J Ultrason, 2018, 18(74): 193-197. DOI: 10.15557/JoU.2018.0029.
[5]
Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis[J]. Pediatrics, 2014, 134(5): e1474-e1502. DOI: 10.1542/peds.2014-2742.
[6]
Gonzalez-Martinez C, Kranzer K, McHugh G, et al. Azithromycin versus placebo for the treatment of HIV-associated chronic lung disease in children and adolescents (BREATHE trial): study protocol for a randomised controlled trial[J]. Trials, 2017, 18(1): 622. DOI: 10.1186/s13063-017-2344-2.
[7]
McCoy E, Chumpia M. Decreasing racemic epinephrine for bronchiolitis in an Academic Children′s Hospital[J]. Hosp Pediatr, 2018, 8(10): 651-657. DOI: 10.1542/hpeds.2017-0214.
[8]
Ruihong Z, Lu W, Xiaoli L. Effect of terbutaline combined with budesonide in treatment of bronchial asthma and rehabilitation nursing[J]. Pak J Pharm Sci, 2018, 31(5 Special): 2249-2255.
[9]
Tominaga N, Tsuruta S, Yukimoto T, et al. Recalcitrant pouchitis treated by budesonide foam: a case report[J]. Nihon Shokakibyo Gakkai Zasshi, 2018, 115(11): 1004-1010. DOI: 10.11405/nisshoshi.115.1004.
[10]
许静，周旭红，邓全敏. 雾化吸入不同剂量重组人干扰素α1b治疗小儿急性毛细支气管炎的疗效比较[J]. 海南医学，2017, 28(13): 2116-2118. DOI: 10.3969/j.issn.1003-6350.2017.13.016.
[11]
Huang X, Zhang X, Wang F, et al. Clinical efficacy of therapy with recombinant human interferon α1b in hand, foot, and mouth disease with enterovirus 71 infection[J]. PLoS One, 2016, 11(2): e0148907. DOI: 10.1371/journal.pone.0148907.
[12]
胡亚美，江载芳. 诸福棠实用儿科学[M]. 7 版. 北京：人民卫生出版社，2007：1199-1200.
[13]
Zhang XM, Lu AZ, Yang HW, et al. Clinical features of postinfectious bronchiolitis obliterans in children undergoing long-term nebulization treatment[J]. World J Pediatr, 2018, 14(5): 498-503. DOI: 10.1007/s12519-018-0193-z.
[14]
Ghazaly M, Nadel S. Overview of prevention and management of acute bronchiolitis due to respiratory syncytial virus[J]. Expert Rev Anti Infect Ther, 2018, 16(12): 913-928. DOI: 10.1080/14787210.2018.1543589.
[15]
Voorham J, Roche N, Benhaddi H, et al. Real-world effectiveness evaluation of budesonide/formoterol Spiromax for the management of asthma and chronic obstructive pulmonary disease in the UK[J]. BMJ Open, 2018, 8(10): e022051. DOI: 10.1136/bmjopen-2018-022051.
[16]
Sipponen MH, Lange H, Ago M, et al. Understanding lignin aggregation processes. a case study: budesonide entrapment and stimuli controlled release from lignin nanoparticles[J]. ACS Sustain Chem Eng, 2018, 6(7): 9342-9351. DOI: 10.1021/acssuschemeng.8b01652.
[17]
靳秀红，汤昱，梁利红，等. 重组人干扰素α1b不同给药方式治疗儿童病毒性肺炎的临床观察[J]. 中国药房，2014, 25(28): 2607-2610. DOI: 10.6039/j.issn.1001-0408.2014.28.05.
[18]
何亚薇，冯斌，吴玫，等. 重组人干扰素α1b雾化吸入治疗婴幼儿呼吸道合胞病毒肺炎的临床研究[J]. 国际病毒学杂志，2015, 22(6): 405-408. DOI: 10.3760/cma.j.issn.1673-4092.2015.06.013.
[19]
Sharma A, Wu W, Sung B, et al. Respiratory syncytial virus (RSV) pulmonary infection in humanized mice induces human anti-RSV immune responses and pathology[J]. J Virol, 2016, 90(10): 5068-5074. DOI: 10.1128/JVI.00259-16.
[20]
申昆玲，张国成. 重视儿童雾化吸入治疗的规范和临床应用研究[J]. 中国实用儿科杂志，2014, 29(11): 837-839. DOI: 10.7504/ek2014110610.
[21]
尚云晓，黄英，刘恩梅，等. 雾化吸入重组人干扰素α1b治疗小儿急性毛细支气管炎多中心研究[J]. 中国实用儿科杂志，2014, 29(11): 840-844. DOI: 10.7504/ek2014110611.
[22]
迟新宇，韩树生，王健. 地氯雷他定片联合布地奈德混悬液雾化吸入治疗小儿毛细支气管炎的效果及对炎症介质的影响[J]. 中国医药导报，2016, 13(26)：76-79.
[1]
Walsh P, Rothenberg SJ. Which ICD-9-CM codes should be used for bronchiolitis research？[J]. BMC Med Res Methodol, 2018, 18(1): 149. DOI: 10.1186/s12874-018-0589-4.
[2]
《中华儿科杂志》编辑委员会, 中华医学会儿科学分会呼吸学组. 毛细支气管炎诊断、治疗与预防专家共识(2014年版)[J]. 中华儿科杂志, 2015, 53(3): 168-171. DOI: 10.3760/cma.j.issn.0578-1310.2015.03.003.
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