小劑量阿奇霉素對(duì)反復(fù)性支氣管炎患兒外周血T淋巴細(xì)胞亞群水平的影響

劉曉燕

[摘要] 目的 探討對(duì)反復(fù)性支氣管炎患兒給予小劑量阿奇霉素治療后外周血T淋巴細(xì)胞亞群水平的影響。 方法 以隨機(jī)綜合序貫法將114例反復(fù)性支氣管炎患兒分為參考組（n=57）和研究組（n=57）。兩組的治療方案分別為常規(guī)療法、小劑量阿奇霉素聯(lián)合常規(guī)療法。對(duì)比治療前后外周血T淋巴細(xì)胞亞群（CD3+、CD4+、CD8+、CD4+/CD8+）水平，統(tǒng)計(jì)臨床療效及安全性。 結(jié)果 治療后研究組與參考組CD3+、CD4+、CD4+/CD8+均升高，且研究組均高于參考組，而兩組CD8+均降低，且研究組低于參考組，T淋巴細(xì)胞亞群指標(biāo)水平本組內(nèi)治療前后和治療后組間的差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；研究組療效分布、總有效率與參考組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；研究組不良反應(yīng)發(fā)生率稍高于參考組，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。 結(jié)論 對(duì)反復(fù)性支氣管炎患兒給予小劑量阿奇霉素能夠提高CD3+、CD4+、CD4+/CD8+水平，降低CD8+水平，增強(qiáng)細(xì)胞免疫功能，并且不會(huì)顯著增加不良反應(yīng)。

[關(guān)鍵詞] 阿奇霉素；反復(fù)性支氣管炎；T淋巴細(xì)胞亞群；不良反應(yīng)

[中圖分類(lèi)號(hào)] R725.6 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2017）35-0043-03

[Abstract] Objective To investigate the effect of low dose azithromycin on the level of peripheral blood T lymphocyte subsets in children patients with recurrent bronchitis. Methods 114 children patients with recurrent bronchitis who were randomLy divided into two groups： the reference group（n=57） and the study group（n=57） by random integrated sequential method. The two groups of treatment options were routine therapy， low-dose azithromycin combined with routine therapy. The levels of peripheral blood T lymphocyte subsets（CD3+， CD4+， CD8+， CD4+/CD8+） before and after the treatment were compared， and the clinical efficacy and safety were statistically analyzed. Results After treatment， the levels of CD3+， CD4+， CD4+/CD8+ in the study group and reference group were both higher， and the study group was higher than the reference group， while the level of CD8+ was lower in both group， and the study group was lower than the reference group. The differences of the levels of T lymphocyte subsets indices in this group before and after treatment and the differences between the two groups after treatment were statistically significant （P<0.05）； there was statistically significant difference between study group and reference group in terms of the efficacy distribution and total efficacy（P<0.05）； the incidence rate of adverse reactions in the study group was slightly higher than that in the reference group， with no statistically significant difference（P>0.05）. Conclusion A small dose of azithromycin in the children patients with recurrent bronchitis can increase the levels of CD3+， CD4+， CD4+/CD8+， reduce the level of CD8+ and enhance the cellular immune function， yet will not significantly increase the adverse reactions.

[Key words] Azithromycin； Recurrent bronchitis； T lymphocyte subsets； Adverse reactions

反復(fù)性支氣管炎是由慢性支氣管炎反復(fù)發(fā)作引發(fā)，其中天氣突變、氣溫驟降、呼吸道小血管痙攣缺血、煙霧粉塵、大氣污染以及機(jī)體免疫功能抑制均是反復(fù)性支氣管炎發(fā)作的重要誘因。反復(fù)性支氣管炎可發(fā)生于各個(gè)年齡段，其中嬰幼兒中的發(fā)病率較高，危害嚴(yán)重[1]。研究指出[2]，反復(fù)性支氣管炎不僅會(huì)影響患兒的機(jī)體健康和生長(zhǎng)發(fā)育，對(duì)其心理健康也可產(chǎn)生嚴(yán)重的威脅，故而需要積極探討高效的治療方案。小劑量阿奇霉素在反復(fù)性支氣管炎患兒中療效確切[3]，但是對(duì)外周血T淋巴細(xì)胞亞群水平的影響研究并不多見(jiàn)。……