吸入皮质激素等对哮喘急性发作患儿诱导痰液中炎性细胞及炎性介质的影响

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。

Influence of inhaled budesonide and salbutamol on inflammatory cells and cytokines concentrations in induced sputum from children with acute asthma

AbstractObjectiveTo investigate influence of inhaled budesonide and salbutamol on inflammatory cells and cytokines concentrations in induced sputum from children with an acute exacerbation of asthma. MethodsChildren with acute asthma (n=34) were treated with inhaled budesonide and salbutamol for 7 days.Children with acute asthma underwent sputum induction,sputum induction was repeated when the children had recovered (n=24).Induced sputum was also taken from 15 healthy children as the controls.Total and differential cell counts were performed.Interleukin 8 (IL 8)、IL 6 and TNF α were measured. ResultsEosinophils,neutrophils,and macrophages decreased significantly at resolution,but eosinophils remained a higher percentage at resolution compared with healthy subjects.Levels of IL 8 、IL 6 and TNF α were elevated during the acute exacerbation and decreased at resolution. ConclusionTherapy of inhaled budesonide and salbutamol can reduce inflammatory cells and cytokines concentrations in induced sputum from children with an acute exacerbation of asthma.