论文部分内容阅读
目的探讨卡介苗(BCG)及其纯蛋白衍生物(PPD)对支气管哮喘(哮喘)患儿的临床控制等级和肺功能的影响,为BCG/PPD在哮喘中的防治提供理论根据。方法安徽医科大学附属省立医院哮喘门诊随机抽取年龄5～14岁哮喘患儿,使用PPD试验筛选出68例PPD试验阴性的哮喘患儿,入组前评估患儿哮喘严重程度,随机分为BCG/PPD干预组(常规治疗并予BCG/PPD干预)和非干预组(仅予常规治疗)。治疗前检测肺功能、评估哮喘病情严重程度。干预组除常规治疗外接种BCG,用PPD试验判定接种成功后,每月皮内注射PPD 5 U,共6个月。每月评估并根据患儿临床控制等级予相应治疗,治疗3个月、6个月时评估2组患儿最大呼气流量占预计值百分比(PEF%)、肺功能、临床症状及临床控制等级的变化。结果 1.临床控制等级:3个月时干预组日间症状、夜间症状、活动受限及临床控制例数与非干预组比较差异均有统计学意义(Pa<0.05);6个月时干预组夜间症状、PEF%改善情况及临床控制例数与非干预组比较差异均有统计学意义(Pa<0.05)。2.肺功能:2组肺功能各指标治疗3个月、6个月时较治疗前均明显改善(Pa<0.05);治疗3个月、6个月时干预组PEF%较非干预组改善(Pa<0.05);6个月时干预组肺功能改善较非干预组明显(Pa<0.05)。结论常规治疗基础上加用BCG/PPD可显著改善哮喘患儿临床症状及肺功能,且在6个月内能持续改善患儿肺功能。
Objective To investigate the effects of BCG and its purified protein derivatives (PPD) on the clinical control and pulmonary function of children with asthma (bronchial asthma), and to provide a theoretical basis for the prevention and treatment of BCG / PPD in asthma. Methods A total of 68 asthmatic children with negative PPD test were screened by PPD test in asthmatic clinic of Provincial Hospital Affiliated to Anhui Medical University. The severity of asthma in children was evaluated before enrollment. The patients were randomly divided into BCG / PPD intervention group (conventional treatment with BCG / PPD intervention) and non-intervention group (conventional treatment only). Pretreatment lung function tests to assess the severity of asthma. The intervention group received routine BCG inoculation, PPD test to determine the success of vaccination, intradermal injection of PPD 5 U per month, a total of 6 months. The patients were evaluated on a monthly basis and treated according to the clinical control level of children. The maximum expiratory flow percentage (PEF%), pulmonary function, clinical symptom and clinical control level in two groups were evaluated at 3 months and 6 months after treatment. The change. Results 1. Clinical control level: There were significant differences in daytime symptom, nocturnal symptom, limited activity and clinical control between intervention group and non-intervention group at 3 months (P <0.05); intervention at 6 months Group night symptoms, PEF% improvement and clinical control cases and non-intervention group differences were statistically significant (Pa <0.05). Pulmonary function: The indexes of pulmonary function in two groups were significantly improved at 3 months and 6 months compared with that before treatment (P <0.05); at 3 and 6 months after treatment, the PEF% of intervention group was better than that of non-intervention group (Pa <0.05). At 6 months, the improvement of pulmonary function in the intervention group was more obvious than that in the non-intervention group (Pa <0.05). Conclusion The addition of BCG / PPD to conventional treatment can significantly improve the clinical symptoms and pulmonary function in children with asthma, and can continue to improve the pulmonary function in children within 6 months.