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目的观察儿童哮喘肺泡灌洗液IL-25变化及布地奈德对其的调节作用。方法选择哮喘急性发作患儿90例,随机分为A、B、C组,每组30例,对照组30例为同期行支气管镜检查的健康儿童。A组给予常规治疗,并予生理盐水雾化治疗4周,B、C组在常规治疗基础上予布地奈德1 mg雾化吸入每日2次,疗程分别为4周、8周。比较治疗前后肺泡灌洗液IL-25变化及与FEV1和EOS相关性。结果治疗前A、B、C组IL-25水平分别为(9.13±1.33)pg/ml、(9.63±2.91)pg/ml、(8.80±2.17)pg/ml,差别无统计学意义(P>0.05),与对照组(1.21±0.63)pg/ml比较,差异有统计学意义(P<0.05);治疗后A、B、C组IL-25水平分别为(7.40±1.83)pg/ml、(5.97±1.85)pg/ml、(3.53±1.57)pg/ml,差别有统计学意义(P<0.01)。支气管肺泡灌洗液(BALF)中IL-25浓度与FEV1和EOS呈明显相关(r=0.832,0.878;P<0.01)。结论治疗前后肺泡灌洗液IL-25水平变化显著,布地奈德能降低哮喘儿童BALF中IL-25水平。
Objective To observe the changes of IL-25 in bronchoalveolar lavage fluid of asthmatic children and the effect of budesonide on it. Methods Ninety children with acute asthma were selected and randomly divided into A, B and C groups, 30 cases in each group, and 30 cases in control group were healthy children undergoing bronchoscopy at the same period. Group A was given routine treatment and was treated with saline for 4 weeks. Group B and C were treated with inhaled budesonide 1 mg twice daily on the basis of conventional treatment for 4 weeks and 8 weeks respectively. The changes of IL-25 in bronchoalveolar lavage fluid before and after treatment were compared with those of FEV1 and EOS. Results The levels of IL-25 in groups A, B and C before treatment were (9.13 ± 1.33) pg / ml, (9.63 ± 2.91) pg / ml and (8.80 ± 2.17) pg / (P <0.05). Compared with the control group (1.21 ± 0.63) pg / ml, the difference was statistically significant (P <0.05). The levels of IL-25 in the groups A, B and C were (7.40 ± 1.83) pg / (5.97 ± 1.85) pg / ml and (3.53 ± 1.57) pg / ml, respectively. The difference was statistically significant (P <0.01). The concentration of IL-25 in bronchoalveolar lavage fluid (BALF) was significantly correlated with FEV1 and EOS (r = 0.832, 0.878; P <0.01). Conclusions The levels of IL-25 in bronchoalveolar lavage fluid before and after treatment vary significantly, and budesonide can reduce the level of IL-25 in BALF of asthmatic children.