益生菌辅助治疗儿童过敏性哮喘的疗效观察及对Th1/Th2免疫失衡和复发风险的影响

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目的 探讨益生菌辅助治疗儿童过敏性哮喘的临床疗效,分析其对Th1/Th2免疫失衡、炎症反应、免疫功能及复发风险的影响。方法 选取2022年1月至2023年12月本院收治的80例过敏性哮喘患儿,按随机数字表法分为对照组和观察组,各40例。对照组接受常规抗哮喘治疗(布地奈德雾化吸入+孟鲁司特钠),观察组结合益生菌进行辅助治疗。比较两组肺功能[第1秒用力呼气容积占预计值百分比(FEV1%)、最大呼气峰流速占预计值百分比(PEF%)]、Th1/Th2细胞因子[干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)、白细胞介素-13(IL-13)]以及治疗总有效率、治疗后6个月内复发率。结果 治疗后,观察组FEV1%、PEF%分别为(87.35±5.21)%、(85.62±4.93)%,高于对照组的(78.44±5.67)%、(76.18±5.20)%(P<0.05)。观察组IFN-γ为(32.58±4.12)pg/mL,高于对照组的(24.36±3.89)pg/mL(P<0.05);IL-4、IL-13分别为(18.27±3.06)pg/mL、(22.14±3.51)pg/mL,低于对照组的(25.63±3.74)pg/mL、(31.05±4.02)pg/mL(P<0.05)。观察组治疗总有效率为92.50%(37/40),高于对照组的75.00%(30/40)(P<0.05)。随访6个月,观察组哮喘复发率为10.00%(4/40),低于对照组的27.50%(11/40)(P<0.05)。结论 益生菌辅助治疗儿童过敏性哮喘可显著改善肺功能及临床症状,调节Th1/Th2免疫失衡,提高临床疗效,并降低复发风险,值得临床推广。
论著

百令胶囊辅助缬沙坦治疗IgA肾病及对肾功能、Th1/Th2漂移、尿PCX、B7-1水平的影响

Effects of Bailing capsules assisting valsartan in the treatment of IgA nephropathy and its influence on renal function, Th1/Th2 drift, urine PCX and B7-1 levels

:46-49
 
目的 观察百令胶囊辅助缬沙坦治疗IgA肾病效果及对患者肾功能、细胞免疫调节、尿足细胞标志蛋白的影响。方法 选取2019年5月—2021年5月西部战区总医院肾内科收治经肾活检确诊为IgA肾病,筛选治疗方案中尚未使用激素及免疫抑制剂的80例患者,按住院先后顺序随机分为观察组和对照组,每组各40例。对照组给予缬沙坦治疗,观察组给予百令胶囊辅助缬沙坦治疗,治疗12周后,比较2组的疗效、治疗前后肾功能指标[24 h蛋白尿(24 h Upro)、尿素氮(BUN)、血肌酐(SCr)、尿红细胞(RBC)计数]、1型/2型辅助性T细胞(Th1/Th2)代表细胞因子[γ-干扰素(IFN-γ)、白介素-4(IL-4)]、尿足细胞标志蛋白[尿足萼糖蛋白(PCX)、尿足细胞B7-1分子(B7-1)]水平。结果 治疗12周后,观察组的治疗总有效率为95.0%,高于对照组的82.5%;观察组的24 h Upro、BUN、SCr、尿RBC计数低于对照组,IFN-γ、Th1/Th2低于对照组、IL-4高于对照组,尿PCX、B7-1水平低于对照组;差异均有统计学意义(P<0.05)。结论 百令胶囊辅助缬沙坦治疗IgA肾病患者,可以提高临床疗效,有效保护患者肾功能,调节其免疫状态,减轻肾损伤。
Objective To observe the effects of Bailing capsules assisting valsartan in the treatment of IgA nephropathy and its influence on renal function, cellular immune regulation and urine prodocytes marker protein. Methods From May 2019 to May 2021, 80 patients with IgA nephropathy confirmed by renal biopsy in the Nephrology Department of Western Theatre Command General Hospital, who had not used hormones or immunosuppressants in the treatment were selected.Patients were divided into observation group and control group according to the order of hospitalization, 40 cases in each group.The control group was given valsartan, and the observation group was given Bailing capsules and valsartan.After 12 weeks of treatment, the efficacy, the levels of renal function indexes [24 h proteinuria (24 h Upro), urea nitrogen (BUN), serum creatinine (SCr), urinary red blood cell (RBC) count], type 1/type 2 helper T cells (Th1/Th2) represent cytokines [interferon-γ (IFN-γ), interleukin-4 (IL-4)], urine prodocytes marker protein [urine podocalyxin (PCX), urinary podocyte B7-1 molecule (B7-1)] before and after treatment were compared between the two groups. Results After treatment, the total effective rate in observation group was higher than that in control group (95.0% vs 82.5%).The 24 h Upro, BUN, SCr levels and urine RBC count in observation group were lower than those in control group, IFN-γ and Th1/Th2 levels were lower than those in control group, the IL-4 level was higher than that in control group, and the levels of urine PCX and B7-1 were lower than those in control group.Those differences were statistically significant (P<0.05). Conclusions Bailing capsules assisting valsartan in the treatment of IgA nephropathy can improve clinical efficacy, effectively protect the renal function of patients, regulate the immune status, and alleviate renal injury.
临床诊疗

孟鲁斯特对哮喘患者外周血Th1/Th2平衡以及外周血炎症因子水平的影响

Peripheral blood Th1/Th2 balance and skin reaction factor level under treatment of Montelukast

:78-80
 
目的 研究孟鲁斯特治疗哮喘的临床疗效及其对患者Th1/Th2细胞免疫平衡和相关炎症因子水平的影响。方法 选取哮喘患者68例随机分为对照组31例及观察组37例,对照组予以常规糖皮质激素吸入治疗,观察组在此基础上加服孟鲁斯特。用药3个月后流式细胞仪检测两组患者外周血Th1、Th2数量变化,ELISA定量外周血IL-4及IFN-γ含量变化并作临床效果评定。结果 两组患者经治疗后,外周血Th1/Th2比例均升高,IL-4/IFN-γ细胞因子水平下降,但观察组较对照组变化更为明显,差异有统计学意义(P<0.01)。疗效方面,观察组总有效率94.59%,高于对照组的74.19%,差异具有统计学意义(P<0.01),同时两组均未见明显不良反应。结论 哮喘患者加用孟鲁斯特具有明显免疫调节功能,使Th1/Th2水平趋于平衡,作为哮喘辅助治疗药物疗效确切。
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