卡介苗/纯蛋白衍生物对支气管哮喘患儿临床症状及肺功能的影响

目的探讨卡介苗(BCG)及其纯蛋白衍生物(PPD)对支气管哮喘(哮喘)患儿的临床控制等级和肺功能的影响,为BCG/PPD在哮喘中的防治提供理论根据。方法安徽医科大学附属省立医院哮喘门诊随机抽取年龄5～14岁哮喘患儿,使用PPD试验筛选出68例PPD试验阴性的哮喘患儿,入组前评估患儿哮喘严重程度,随机分为BCG/PPD干预组(常规治疗并予BCG/PPD干预)和非干预组(仅予常规治疗)。治疗前检测肺功能、评估哮喘病情严重程度。干预组除常规治疗外接种BCG,用PPD试验判定接种成功后,每月皮内注射PPD 5 U,共6个月。每月评估并根据患儿临床控制等级予相应治疗,治疗3个月、6个月时评估2组患儿最大呼气流量占预计值百分比(PEF%)、肺功能、临床症状及临床控制等级的变化。结果 1.临床控制等级:3个月时干预组日间症状、夜间症状、活动受限及临床控制例数与非干预组比较差异均有统计学意义(Pa<0.05);6个月时干预组夜间症状、PEF%改善情况及临床控制例数与非干预组比较差异均有统计学意义(Pa<0.05)。2.肺功能:2组肺功能各指标治疗3个月、6个月时较治疗前均明显改善(Pa<0.05);治疗3个月、6个月时干预组PEF%较非干预组改善(Pa<0.05);6个月时干预组肺功能改善较非干预组明显(Pa<0.05)。结论常规治疗基础上加用BCG/PPD可显著改善哮喘患儿临床症状及肺功能,且在6个月内能持续改善患儿肺功能。

Influence of Bacillus Calmette - Guerin Vaccine / Purified Protein Derivatives on Clinical Symptom and Lung Function of Children with Bronchial Asthma

Objective To observe the effect of bacillus calmette-guerin vaccine(BCG) and purified protein derivatives(PPD)on the clinical control level and lung function of asthmatic children,and to provide theoretical basis for the prevention and treatment of asthma. Me-thods Sixty-eight asthmatic children were selected randomly from Anhui Provincial Hospital Asthma Clinic,who were 5 to 14 years old,the PPD test results were negative,and they were randomly divided into BCG/PPD group and control group.The severity of asthma in each children was evaluated before enrollment.The children in BCG/PPD group were intervened by BCG/PPD therapy and the conventional treatment,but the children in control group were given conventional treatment only.Every children′s lung function and the severity of asthma were eva-luated before treatment.PPD test was used to examine the results of the vaccination,the children who were vaccinated successfully were injected 5 units PPD subcutaneously each month.The clinical control level was evaluated at every month,and given corresponding treatment.The peak expiratory flow accounting for predicted value(PEF%),lung function,clinical symptoms and clinical control level in BCG/PPD group and the control group were evaluated at 3 months and 6 months after treatment. Results 1.The clinical control level:The daytime symptoms,night symptoms,activity limitation,clinic controlled number in BCG/PPD group had statistical differences compared with those in the control group 3 months after treatment(Pa<0.05).The night symptoms,the improvement of PEF% and clinic controlled number in BCG/PPD group had statistical differences compared with those in control group 6 months after treatment(Pa<0.05).2.The lung function:The lung function in the 2 groups 3 months and 6 months after treatment had statistically significant differences compared with that before treatment(Pa<0.05).The PEF% in BCG/PPD group at 3 months after treatment had statistical difference compared with those of the control group(P<0.05).The lung function in BCG/PPD group 6 months after treatment had statistical difference compared with control group(P<0.05). Conclusions Adding BCG/PPD combined with conventional treatment could improve asthmatic children′s clinical symptoms and their lung function persistently in 6 months.