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

doi:10.3877/cma.j.issn.1673-5250.2021.03.010

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(%)]
组别	例数	男	女	年龄(月，±s)	病程(d，±s)	母乳喂养[例数(%)]
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(%)]
组别	例数	男	女	年龄(月，±s)	病程(d，±s)	母乳喂养[例数(%)]
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⁺
组别	例数	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⁺
组别	例数	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
组别	例数	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
组别	例数	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
组别	例数	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

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
组别	例数	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

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