皮下免疫治疗联合奥马珠单抗对支气管哮喘患儿肺功能及血清炎症因子的影响

doi:10.3760/cma.j.cn441417-20240605-13016

摘要/Abstract

摘要：

目的　探究皮下免疫治疗联合奥马珠单抗对支气管哮喘患儿肺功能及血清炎症因子的影响。方法　本研究为随机对照试验。选取2022年1月至2022年12月西安市儿童医院急诊科收治的104例支气管哮喘患儿作为研究对象。采用单双数标记法，将患儿随机分为对照组（52例）和研究组（52例）。对照组男31例，女21例；年龄（10.44±1.26）岁；病程（1.92±0.47）年。研究组男33例，女19例；年龄（10.22±1.21）岁；病程（1.86±0.56）年。对照组采用奥马珠单抗治疗，研究组在对照组基础上联合皮下免疫治疗。两组均持续治疗12个月。比较两组治疗前后肺功能［第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC］、血清炎症因子［白细胞介素-2（IL-2）、IL-4、IL-6、γ干扰素（IFN-γ）］、免疫指标［嗜酸性粒细胞（EOS）、免疫球蛋白E（IgE）、免疫球蛋白辅助型T细胞2（Th2）、免疫球蛋白Th17、CD4+、CD8+、CD4+/CD8+］，不良反应发生情况。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　治疗后，研究组FEV1、FVC及FEV1/FVC均高于对照组［（1.92±0.70）L比（1.68±0.63）L、（2.19±0.63）L比（1.81±0.56）L、（79.80±7.31）%比（68.83±6.82）%］（均P<0.05）；研究组血清IL-2、IFN-γ水平均高于对照组［（26.43±5.13）ng/L比（21.04±4.78）ng/L、（326.81±24.60）ng/L比（291.62±20.84）ng/L］，血清IL-4、IL-6水平均低于对照组［（157.15±29.52）ng/L比（279.71±31.77）ng/L、（10.05±2.90）ng/L比（16.11±3.51）ng/L］（均P<0.05）；研究组CD4+水平、CD4+/CD8+均高于对照组，EOS、IgE、Th2、Th17水平均低于对照组（均P<0.05）。两组不良反应总发生率比较，差异无统计学意义（P>0.05）。结论　皮下免疫治疗联合奥马珠单抗可提高支气管哮喘患儿肺功能，改善血清炎症因子和免疫指标，安全性较好。

关键词: 支气管哮喘, 皮下免疫, 奥马珠单抗, 肺功能, 炎症因子, 不良反应

Abstract:

Objective　To evaluate the effect of subcutaneous immunotherapy combined with omalizumab on lung function and serum inflammatory markers in children with bronchial asthma. Methods　This study is a randomized controlled trial. A total of 104 children with bronchial asthma who were admitted to the emergency department of Xi'an Children's Hospital from January 2022 to December 2022 were selected as the study subjects. Using the odd-even numbering method, the children were randomly divided into the control group (52 cases) and the study group (52 cases). There were 31 boys and 21 girls in the control group, aged (10.44±1.26) years, course of the disease (1.92±0.47) years. There were 33 boys and 19 girls in the study group, aged (10.22±1.21) years, course of the disease (1.86±0.56) years. The control group was treated with omalizumab, while the study group received subcutaneous immunotherapy in addition to the treatment of the control group. Both groups were treated continuously for 12 months. The lung function [first-second forced expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC], serum inflammatory markers [interleukin-2 (IL-2), IL-4, IL-6, gamma interferon (IFN-γ)], immune indicators [eosinophils (EOS), immunoglobulin E (IgE), immunoglobulin helper type T cell 2 (Th2), immunoglobulin Th17, CD4+, CD8+, CD4+/CD8+] were compared between the two groups before and after treatment, as well as the occurrence of adverse reactions. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the FEV1, FVC and FEV1/FVC in the study group were all higher than those in the control group [(1.92±0.70) L vs. (1.68±0.63) L, (2.19±0.63) L vs. (1.81±0.56) L, (79.80±7.31)% vs. (68.83±6.82)%] (all P<0.05); the serum levels of IL-2 and IFN-γ in the study group were higher than those in the control group [(26.43±5.13) ng/L vs. (21.04±4.78) ng/L, (326.81±24.60) ng/L vs. (291.62±20.84) ng/L], while the serum levels of IL-4 and IL-6 were lower than those in the control group [(157.15±29.52) ng/L vs. (279.71±31.77) ng/L, (10.05±2.90) ng/L vs. (16.11±3.51) ng/L] (all P<0.05); the levels of CD4+ and CD4+/CD8+ in the study group were higher than those in the control group, while the levels of EOS, IgE, Th2 and Th17 were lower than those in the control group (all P<0.05). The comparison of the total incidence rates of adverse reactions between the two groups showed no statistically significant difference (P>0.05). Conclusion　Subcutaneous immunotherapy combined with omalizumab can improve the lung function of children with bronchial asthma, enhance the levels of serum inflammatory markers and immune indicators, and has good safety.

Key words: Bronchial asthma, , Subcutaneous immunotherapy, , Omalizumab, , Lung function, , Inflammatory markers, , Adverse reactions

陈瑶郑茂.

皮下免疫治疗联合奥马珠单抗对支气管哮喘患儿肺功能及血清炎症因子的影响 [J]. 国际医药卫生导报, 2025, 31(13): 2192-2196.

Chen Yao, Zheng Mao.

The effect of subcutaneous immunotherapy combined with omalizumab on lung function and serum inflammatory markers in children with bronchial asthma [J]. International Medicine and Health Guidance News, 2025, 31(13): 2192-2196.

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