Exploration of azithromycin on secondary prevention of asthma / 国际儿科学杂志

ABSTRACT

Objective To discuss the effect of azithromycin on the airway inflammation in children at high risk for asthma by detecting the serum concentration change of eosinophil cationic protein(ECP), intedeukin-8(IL-8) and nitrogen oxide(NO), and also to explore the effect of azithromycin on secondary prevention of asthma. Methods Two hundred and twenty three cases of primary asthmatic attack with atopy (eczema, family asthmatic history) were collected and divided into four groups(group A, B,C,D) after asthmatic symptoms relief, group A was taken orally with azithromycin(5mg/kg Biw), group B was inhaled budesonide(0.5mg Bid), group C was taken orally with singulair (4mg qN),and group D was only given with symptomatic treatment. The vein blood was sampled on the first day in hospital, before and after medication respectively when treatment of three months was completed. Serum concentration of ECP and IL-8 was obtained by ELISA methods, and NO was measured by nitric acid enzyme reduction method. Clinic service and telephone follow-up was taken for one year. Results After three monthes intervention, there was significant difference in the serum concentration of ECP, IL-8 and NO at group A, B, C compared with group D( P<0.01 ). There was no significant difference in decrease of ECP and NO between group A and B( P > 0.05), but decrease of ECP and NO in group C was significant difference compared with group A( P<0.01). The serum concentration of IL-8 in each group was obviously decreased especially in group A, and difference was obvious between group A and group B,C( P<0.01). There was no significant difference in the cases of asthma recurrence within three months and asthmatic recurrence within one year between group A and group B, group C and group D respectively. Conchlsions (1)The medication of azithromycin might result to decrease the serum concentration of ECP and NO, especially for IL-8 in children at high risk for asthma. (2)The effects of azithromycin on change of ECP and NO in children at high risk for asthma were similar to budesonide, but different with montelukast, while the inhabitant effects of IL-8 were different with inhaled steroid hormone and leukotriene receptor obviously. (3)There was some valid contribution of azithromycin actting on the secondary prevention of asthma in our investigation.