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目的了解布地奈德联合沙丁胺醇雾化吸入治疗儿童哮喘急性发作前后其气道炎性细胞、白细胞介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)的变化,探讨其影响机制。方法对上海市第五人民医院2002-09—2003-12收治的急性哮喘发作患儿采用上述联合治疗1周,共对34例急性发作期、24例缓解期患儿和15名正常儿童的诱导痰液进行炎性细胞计数和分类,测定其中IL-6、IL-8、TNF-α水平。结果急性期哮喘患儿的总细胞数、嗜酸性细胞、中性粒细胞和单核细胞比例及IL-8、IL-6、TNF-α水平均高于正常对照组。缓解期哮喘患儿除嗜酸细胞及淋巴细胞比例明显高于正常对照组外,其余上述炎性细胞比例及细胞因子水平均降至正常。结论布地奈德联合沙丁胺醇雾化吸入可显著降低急性哮喘发作患儿气道分泌物内嗜酸性细胞、中性粒细胞和单核细胞数量及IL-8、IL-6、TNF-α水平。
Objective To investigate the changes of airway inflammatory cells, interleukin-6 (IL-6), interleukin-8 and tumor necrosis factor-α (TNF-α) in asthmatic children before and after acute inhalation of budesonide combined with salbutamol inhalation , Explore its impact mechanism. Methods Acute asthmatic children admitted to the Fifth People ’s Hospital of Shanghai from September 2002 to December 2003 were enrolled in this study. The combined treatment was performed for one week in 34 patients with acute exacerbation, 24 with remission and 15 normal children Sputum count and classification of inflammatory cells, determination of IL-6, IL-8, TNF-α levels. Results The total number of cells, eosinophils, neutrophils and monocytes and the levels of IL-8, IL-6 and TNF-α in children with acute asthma were higher than those in normal controls. In addition, the percentage of eosinophils and lymphocytes in asthmatic children during remission period was significantly higher than that in normal control group, while the proportion of inflammatory cells and cytokines in the remission period were all reduced to normal. Conclusion Budesonide combined with salbutamol inhalation can significantly reduce the number of eosinophils, neutrophils and monocytes and the levels of IL-8, IL-6 and TNF-α in airway secretions of children with acute asthmatic attack.