静脉滴注丙种球蛋白治疗急性毛细支气管炎的研究

应用静脉滴注丙种球蛋白（IVIg）治疗毛细支气管炎25例，以30例应用新鲜血浆或血液者为对照，结果无论是临床症状、体征，还是体液免疫功能变化，均较对照组好转、恢复快，并且没有出现任何后遗症和死亡病例。     

Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study

Inuit infants have extremely high rates of lower respiratory tract infection (LRTI), but the causes for this are unclear. The aims of this study were to assess, in young Inuit children in Baffin Region, Nunavut, the feasibility of an epidemiologic study of the association between indoor air quality (IAQ) and respiratory health; to obtain data on IAQ in their housing; and to identify and classify risk factors for LRTI. Twenty houses in Cape Dorset, Nunavut with children below 2 years of age, were evaluated using a structured housing inspection and measurement of IAQ parameters, and a respiratory health questionnaire was administered. Twenty-five percent of the children had, at some time, been hospitalized for chest illness. Houses were very small, and had a median of six occupants per house. Forty-one percent of the houses had a calculated natural air change rate <0.35 air changes per hour. NO(2) concentrations were within the acceptable range. Smokers were present in at least 90% of the households, and nicotine concentrations exceeded 1.5 microg/m(3) in 25% of the dwellings. Particulates were found to be correlated closely with nicotine but not with NO(2) concentrations, suggesting that their main source was cigarette smoking rather than leakage from furnaces. Mattress fungal levels were markedly increased, although building fungal concentrations were low. Dust-mites were virtually non-existent. Potential risk factors related to IAQ for viral LRTI in Inuit infants were observed in this study, including reduced air exchange and environmental tobacco smoke exposure. Severe lower respiratory tract infection is common in Inuit infants. We found reduced air change rates and high occupancy levels in houses in Cape Dorset, which may increase the risk of respiratory infections. This suggests the measures to promote better ventilation or more housing may be beneficial. Further health benefits may be obtained by reducing bed sharing by infants and greater turnover of mattresses, which were found to have high levels of fungi.     

孟鲁司特对毛细支气管炎患儿尿白三烯E4水平的影响

目的: 观察孟鲁司特对毛细支气管炎患儿尿白三烯E4(LTE4)水平的影响。方法: 将69例急性期毛支患儿随机分为孟鲁司特治疗组和常规治疗组,对两组进行疗效比较及尿LTE4测定;同时对48例缓解期毛支分别予孟鲁司特和丙酸氟替卡松吸入,1个月后观察两组的尿LTE4水平变化。结果: 孟鲁司特组气急消失时间、体征消失时间和住院时间均较常规组缩短(P<0.01)。毛支治疗前,孟鲁司特组和常规组尿LTE4水平比较无统计学差异(P>0.05),与对照组比较,两者均明显升高(P<0.01);治疗后,孟鲁司特组尿LTE4水平较常规组明显下降,差异有统计学意义(P<0.01),与对照组比较无统计学意义(P>0.05);而常规组尿LTE4水平仍高于对照组(P<0.01)。毛支缓解后,分别予孟鲁司特和丙酸氟替卡松吸入治疗1个月,结束治疗后孟鲁司特组尿LTE4水平明显低于激素吸入组。结论: 孟鲁司特可有效降低毛支患儿急性期及缓解期尿LTE4水平,改善毛支患儿的临床症状。     

儿童闭塞性细支气管炎的CT诊断价值

目的:评价儿童闭塞性细支气管炎(BO)的CT特点,提高对本病的认识。方法:回顾性分析11例儿童BO的临床及CT资料。结果:11例BO患儿均为感染后发生。3例行电子纤维支气管镜检查提示有支气管内膜慢性炎症。CT检查示外周细支气管扩张、管壁增厚4例,支气管黏液1例,马赛克灌注征9例,肺实变5例。结论:儿童BO常继发感染,CT对其早期诊断具有重要价值。     

紫苑、款冬花、白芷佐治毛细支气管炎患儿100例疗效观察

目的观察紫苑、款冬花、白芷佐治毛细支气管炎的临床疗效。方法160例毛细支气管炎患儿随机分为治疗组100例,对照组60例,对照组给予抗感染、吸氧,口服β2受体激动剂等西医综合治疗,治疗组在上述治疗基础上加用紫苑,款冬花,白芷三味中药。观察2组症状、体征改善情况并作统计学分析。结果治疗组喘憋症状缓解、哮鸣音消失及总住院时间均短于对照组,差异有统计学意义(P<0.01)。结论紫苑,款冬花,白芷佐治毛细支气管炎疗效明显。     

氧驱动雾化吸入氨溴索辅助治疗毛细支气管炎疗效观察

目的探讨氧驱动雾化吸入氨溴索辅助治疗毛细支气管炎临床效果。方法将52例毛细支气管炎患者随机分为治疗组和对照组各26例,对照组常规给以抗感染、平喘、糖皮质激素等基础治疗;治疗组在常规治疗的基础上给以盐酸氨溴索注射液15mg加入生理盐水2ml氧驱动雾化吸入,每日2次,疗程7天。结果治疗组患者咳嗽及肺痰鸣音持续时间明显短于对照组(P<0.05);憋喘、哮鸣音和治愈时间显著短于对照组(P<0.01)。结论氨溴索氧驱动雾化吸入治疗毛细支气管炎可明显提高疗效,缩短治疗时间。     

Bronchoalveolar lavage fluid proteomic patterns of sulfur mustard-exposed patients

Sulfur mustard is an alkylating agent that reacts with ocular, respiratory, cutaneous, and bone marrow tissues. Main late respiratory complications are chronic obstructive pulmonary disease, bronchiectasis, asthma, and bronchiolitis obliterans. The aim of the present study was to identify differentially expressed proteins in bronchoalveolar lavage (BAL) fluid of control healthy and sulfur mustard-exposed lung disease patients. The BAL protein profile of ten healthy and 30 exposed patients with mild, moderate, and severe conditions (ten males in each group) were separated with 2-D SDS-PAGE and differentially expressed protein spots were successfully identified with MALDI TOF TOF MS. Among the differentially expressed proteins we observed a significant increase in vitamin D binding protein isoforms, haptoglobin isoforms, and fibrinogen especially in exposed moderate and severe lung diseases patients (p<0.01). Moreover, compared with healthy controls, significant decreases was noted in calcyphosine, surfactant protein A, and transthyretin in these patients (p<0.01). Apolipoprotein A1 was detected in all patients' BAL fluid but none of the healthy controls. Furthermore, S100 calcium-binding protein A8 was only detected in BAL fluid of moderate and severe groups. These findings will be useful to improve current methods of monitoring and helps to identify new therapeutic targets for treatment of this complicated illness.