RESUMO
ObjectiveTo understand the relationship between mycoplasm load in bronchoalveolar lavage lfuid (BALF) with the status of Th1/Th2 immune response in children withMycoplasma pneumoniae pneumonia (MPP).MethodsThe levels of IL-4, IFN, IL-8 , TNF-α in BLAF and total IgE, ECP in serum from 90 children with MPP were measured by ELISA.MP DNA in BALF was detected quantitatively by lfuorescent real-time PCR. Children with MPP (n=90) were divided into two groups of low MP-DNA load (n=24) and high MP-DNA load (n=26) according to the copies of MP DNA in BALF. The cytokines in BALF, and total IgE and ECP in serum were compared between the two groups. The relationship between the levels of cytokines in BLAF and the copies was evaluated.ResultsThe levels of IL-4 and the IL-4/IFN ratio in BALF from the high DNA-load group were signiifcantly higher than that of the low group (t=4.280, 2.076, allP<0.05). The level of IL-4 was signiifcantly correlated with the copies of MP-DNA in BALF from children with MPP (r=0.509,P<0.05). The percentage of total IgE and ECP positive result in serum from the high DNA-load group is higher than that of the low group. (χ2=24.638, 6.392,allP<0.05).Conclusion Infection with high-load MP in children may cause the imbalance of Th1/Th2. And the Th2 cytokines response seems predomi-nant.
RESUMO
Objective Early studies had confirmed that the combine-sequential therapy in the treatment of acute attacks of wheezing infants was safe and effective,this study aims to further explore the role of oral azithromycin in the combine-sequential therapy.Methods According to the principles of randomized,56 wheezing infants were divided into Azithromycin group and control group from Aug.2012 to Apr.2013,and there were 29 children in the Azithromycin group and 27 children in the control group.The treatment protocol of Azithromycin group were oral Azithromycin 10 mg/(kg · d),3 days; oral prednisone 5 mg/d,3 days; Tulobuterol Patch 0.5 mg/d,7 days;oral Ioratadine 3 mL/d,7 days; oral Montelukast 4 mg/d,7 days.Control group was without Azithromycin,and the rest of drugs were the same as Azithromycin group.The symptom scores of coughing,wheezing,wheezing sound and the difficulty of expectoration in the 1 st day,the 3rd day,and the 7th day were recorded.Results 1.The Azithromycin group and the control group could both improve the children's symptom scores of coughing,wheezing,wheezing sound and the difficulty of expectoration,the 2 groups of children before and after treatment of the symptom scores differences were statistically significant (5.41 ± 1.40,4.85 ± 1.13 vs 1.14 ± 0.78,2.93 ± 1.00) (S =217.5,147.0,all P ＜ 0.05).2.The Azithromycin group had more improvement at the symptom scores of coughing,wheezing,wheezing sound and the difficulty of expectoration than those of the control group in the third day (0.52 ±0.51,0.28 ±0.45,0.24 ±0.44,0.38 ±0.49 vs 0.89 ± 0.42,0.74 ±0.45,0.62 ±0.69,0.67 ±0.48)and the 7th day (0.24 ±0.44,0.21 ±0.41,0.07 ±0.26,0.21 ±0.41 vs 0.52 ±0.51,0.48 ±0.51,0.37 ±0.49,0.48 ±0.51),and the symptom score differences were statistically significant(Z =2.75,3.44,2.90,2.12,2.11,2.13,2.71,2.13,all P ＜ 0.05).Conclusions Azithromycin + Tulobuterol patch + Prednisone + Loratadine + Montelukast combination consisting of sequential therapy can improve children with acute wheezing cough,wheezing,wheezing,difficulty of the expectoration symptoms,azithromycin is an effective component of infants wheezing combined sequential treatment regimen.