维生素D联合布地奈德治疗儿童肺炎支原体肺炎的临床研究OA北大核心CSTPCD
Clinical trial of vitamin D combined with budesonide in the treatment of Mycoplasma pneumoniae pneumonia in children
目的 分析维生素D联合布地奈德混悬液治疗儿童肺炎支原体肺炎的临床疗效,及其对外周血T淋巴细胞亚群与血清白细胞介素-17(IL-17)、超敏C-反应蛋白(hs-CRP)的影响.方法 将重症肺炎支原体肺炎患儿随机分为对照组和试验组.对照组给予布地奈德雾化吸入治疗,≤7岁,每次1 mL;＞7岁,每次2 mL,bid,治疗2周;试验组在对照组治疗的基础上,给予维生素D口服治疗,400 U,qd,治疗2周.比较2组患儿的临床疗效、临床症状和体征消失时间、外周血T淋巴细胞亚群水平、血清IL-17、hs-CRP、25羟维生素D[25(OH)D]水平,以及药物不良反应的发生情况.结果 试验过程中共脱落11例,最终试验组和对照组分别纳入40例.治疗后,试验组和对照组的总有效率分别为97.50％(39例/40例)和82.50％(33例/40例),在统计学上差异有统计学意义(P＜0.05).治疗后,试验组和对照组的咳嗽消失时间分别为(5.14±1.08)和(6.87±1.24)d,啰音消失时间分别为(6.69±1.21)和(8.52±1.29)d,CD3+水平分别为(68.03±5.68)％和(64.61±6.84)％,CD4+水平分别为(44.26±5.83)％和(39.94±5.01)％,CD4+/CD8+水平分别为 1.37±0.33 和 1.24±0.21,血清IL-17 水平分别为(22.84±4.13)和(39.21±8.68)pg·mL-1,hs-CRP 水平分别为(3.25±0.72)和(6.07±1.11)mg·L-1,25(OH)D 水平分别为(36.42±6.86)和(24.25±6.03)ng·mL-1,在统计学上差异均有统计学意义(均P＜0.05).治疗期间,2组患儿的药物不良反应均以腹泻、呕吐、腹部不适、咽喉刺激为主.试验组和对照组的总药物不良反应发生率分别为22.50％和17.50％,在统计学上差异无统计学意义(P＞0.05).结论 维生素D联合布地奈德混悬液治疗儿童肺炎支原体肺炎的临床疗效显著,可有效缓解症状,调节患儿T淋巴细胞亚群水平,并降低血清IL-17、hs-CRP水平,安全性较好.
Objective To analyze the clinical effect of vitamin D combined with budesonide suspension in the treatment of Mycoplasma pneumoniae pneumonia in children and the influence on peripheral blood T lymphocyte subsets and serum interleukin-17(IL-17)and hypersensitive C-reactive protein(hs-CRP).Methods Children with severe Mycoplasma pneumoniae pneumonia were classified into control group and treatment group by adopting the random number table method.The control group was treated with budesonide aerosol inhalation therapy(1 mL for ≤7 years old,2 mL for＞7 years old,twice a day for 2 weeks),and the treatment group was additionally given oral administration of vitamin D(400 U,once a day for 2 weeks).The clinical effect,disappearance times of clinical symptoms and signs,peripheral blood T lymphocyte subsets,serum IL-17,hs-CRP and 25-hydroxy vitamin D(25(OH)D)and occurrence of adverse drug reactions were compared between both groups of children.Results Eleven cases dropped out during treatment,and finally forty cases were included in treatment group and control group respectively.After treatment,the total effective rates in treatment group and control group were 97.50％(39 cases/40 cases)and 82.50％(33 cases/40 cases);the cough disappearance times were(5.14±1.08)and(6.87±1.24)d;the rale disappearance times were(6.69±1.21)and(8.52±1.29)d;CD3+levels were(68.03±5.68)％and(64.61±6.84)％;CD4+levels were(44.26±5.83)％and(39.94±5.01)％;CD4+/CD8+levels were 1.37±0.33 and 1.24±0.21;serum IL-17 levels were(22.84±4.13)and(39.21±8.68)pg·mL-1;hs-CRP levels were(3.25±0.72)and(6.07±1.11)mg·L-1;25(OH)D levels were(36.42±6.86)and(24.25±6.03)ng·mL-1,respectively(all P＜0.05).During the treatment period,the adverse drug reactions of the two groups were mainly diarrhea,vomiting,abdominal discomfort and throat irritation.The total incidence of adverse drug reactions in treatment group and control group was 22.50％and 17.50％,respectively,and there was no statistically significant difference(P＞0.05).Conclusion Vitamin D combined with budesonide suspension has a significant clinical effect in the treatment of Mycoplasma pneumoniae pneumonia in children,and it can effectively relieve symptoms,regulate the levels of T lymphocyte subsets,and reduce the levels of serum IL-17 and hs-CRP,with good safety.
张敏;梁立东;顾洁;张中林
银川市妇幼保健院儿科,宁夏回族自治区银川 750004银川市第二人民医院 儿科,宁夏回族自治区 银川 750011
药学
维生素D布地奈德混悬液儿童肺炎支原体肺炎T淋巴细胞亚群
vitamin Dbudesonide suspensionchildrenMycoplasma pneumoniae pneumoniaT lymphocyte subsets
《中国临床药理学杂志》 2024 (007)
939-943 / 5
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