人干扰素α-1b雾化联合布地奈德对呼吸道合胞病毒重症肺炎患儿血清CCL5、CCL11指标及临床疗效的影响

doi:10.3969/j.issn.1006-5725.2026.15.019

摘要/Abstract

摘要：

目的探讨人干扰素α-1b雾化联合布地奈德对呼吸道合胞病毒（RSV）重症肺炎患儿血清趋化因子配体5（CCL5）、趋化因子配体11（CCL11）指标及临床疗效的作用。方法前瞻性纳入2022年3月至2025年2月宁夏医科大学总医院收治的RSV重症肺炎患儿270例，采用随机数字表分为对照组（n = 135）和观察组（n = 135）。两组均接受基础对症治疗，对照组接受布地奈德雾化吸入治疗，观察组在对照组基础上接受人干扰素α-1b雾化治疗。比较治疗后症状改善时间，治疗前后血清CCL5、CCL11水平、Th1/Th2免疫平衡指标、气道重塑和氧化应激指标、血气指标及不良反应。结果观察组咳嗽消失时间、喘息消失时间、肺部啰音消失时间低于对照组（P < 0.05）；治疗后，观察组血清CCL5、CCL11低于对照组（P < 0.05）；观察组白细胞介素-4（IL-4）低于对照组，γ干扰素（IFN-γ）、IFN-γ/IL-4比值高于对照组（P < 0.05）；观察组黏蛋白5AC（MUC5AC）、8-羟基脱氧鸟苷（8-OHdG）低于对照组，超氧化物歧化酶（SOD）高于对照组（P < 0.05）；观察组动脉血氧分压（PaO₂）、氧合指数（PaO?/FiO?）、血氧饱和度（SpO?）高于对照组（P < 0.05）；两组总不良反应发生率比较差异无统计学意义（P > 0.05）。结论人干扰素α-1b联合布地奈德雾化吸入治疗RSV重症肺炎患儿可显著改善临床症状，通过下调血清CCL5、CCL11水平，调节Th1/Th2免疫指标水平，抑制气道重塑，减轻氧化应激损伤，改善血气状态，均具有较高安全性。

关键词: 人干扰素α-1b, 布地奈德, 呼吸道合胞病毒, 重症肺炎, 儿童

Abstract:

Objective To investigate the effects of nebulized human interferon alpha-1b in combination with budesonide on the levels of serum chemokine ligand 5 （CCL5） and chemokine ligand 11 （CCL11） and the clinical efficacy in children with severe respiratory syncytial virus （RSV） pneumonia. Methods A total of 270 children with severe RSV pneumonia who were admitted to Ningxia Medical University General Hospital from March 2022 to February 2025 were prospectively included and randomly divided into a control group （n = 135） and an observation group （n = 135） using a random number table. Both groups received basic symptomatic treatment. Specifically， the control group received budesonide nebulization inhalation treatment， while the observation group received human interferon alpha-1b nebulization treatment on the basis of the treatment given to the control group. The improvement time of symptoms after treatment， serum CCL5 and CCL11 levels， Th1/Th2 immune balance indicators， airway remodeling and oxidative stress indicators， blood gas indicators， and adverse reactions before and after treatment were compared. Results The disappearance time of cough， wheezing， and lung rales in the observation group was shorter than that in the control group （P < 0.05）. After treatment， the serum levels of CCL5 and CCL11 in the observation group were lower than those in the control group （P < 0.05）. The levels of interleukin-4 （IL-4） in the observation group were lower than those in the control group， while the levels of interferon gamma （IFN-γ） and the IFN-γ/IL-4 ratio were higher than those in the control group （P < 0.05）. The observation group had lower levels of mucin 5AC （MUC5AC） and 8-hydroxydeoxyguanosine （8-OHdG） and higher levels of superoxide dismutase （SOD） compared to the control group （P < 0.05）. The arterial partial pressure of oxygen （PaO₂）， oxygenation index （PaO₂/FiO₂）， and blood oxygen saturation （SpO₂） in the observation group were higher than those in the control group （P < 0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups （P > 0.05）. Conclusions The combination of human interferon alpha-1b and budesonide nebulized inhalation therapy can remarkably enhance the clinical symptoms in children suffering from severe RSV pneumonia. Through down-regulating the levels of serum CCL5 and CCL11， regulating the levels of Th1/Th2 immune index， inhibiting airway remodeling， lessening oxidative stress damage， and improving blood gas status， this combination therapy demonstrates high safety.

Key words: human interferon alpha-1b, budesonide, respiratory syncytial virus, severe pneumonia, child

中图分类号:

R725.6

张银娟,闫亚萍,王艳荣. 人干扰素α-1b雾化联合布地奈德对呼吸道合胞病毒重症肺炎患儿血清CCL5、CCL11指标及临床疗效的影响[J]. 实用医学杂志, 2026, 42(15): 2824-2831.

Yinjuan ZHANG,Yaping YAN,Yanrong WANG. The effect of nebulization of human interferon alpha-1b combined with budesonide on serum CCL5 and CCL11 levels and clinical efficacy in children with severe respiratory syncytial virus pneumonia[J]. The Journal of Practical Medicine, 2026, 42(15): 2824-2831.

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项目	对照组（n = 135）	观察组（n = 135）	Z/χ²/t值	P值
年龄［M（P₂₅，P₇₅）］/月	20（3，36）	20（4，35）	0.184	0.854
性别/［例（%）］			0.245	0.620
男	78	82
女	57	53
体质量/kg	10.23 ± 1.45	10.41 ± 1.39	1.041	0.299
病程/d	3.15 ± 1.08	3.17 ± 1.05	0.172	0.864
发热峰值/℃	38.13 ± 0.56	38.08 ± 0.59	0.714	0.476
心率/（次/min）	142.37 ± 12.24	143.12 ± 11.89	0.510	0.611
基础病史/例			0.232	0.630
有	22	25
无	113	110
WBC/（×10⁹·L^-1）	12.38 ± 3.19	12.41 ± 3.27	0.094	0.925
CRP/（mg/L）	15.27 ± 3.26	15.17 ± 3.19	0.245	0.807

组别	咳嗽消失时间	喘息消失时间	肺啰音消失时间
对照组（n = 135）	10.71 ± 1.42	4.56 ± 1.23	5.98 ± 1.31
观察组（n = 135）	9.02 ± 1.26	3.19 ± 0.87	4.26 ± 1.18
t值	10.343	10.636	11.321
P值	0.000	0.000	0.000

组别	CCL5/（ng/mL）		CCL11/（pg/mL）
组别	治疗前	治疗后	治疗前	治疗后
对照组（n = 135）	42.36 ± 6.59	29.76 ± 5.00^*	186.43 ± 26.49	113.58 ± 17.49^*
观察组（n = 135）	43.01 ± 5.96	21.24 ± 4.36^*	189.51 ± 24.86	85.49 ± 15.33^*
t值	0.850	14.899	0.985	14.030
P值	0.396	0.000	0.325	0.000

组别	IL-4/（pg/mL）		IFN-γ/（pg/mL）		IFN-γ/IL-4
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 135）	32.86 ± 5.89	24.58 ± 5.26^*	18.46 ± 4.26	25.34 ± 5.11^*	0.57 ± 0.12	1.03 ± 0.21^*
观察组（n = 135）	33.10 ± 6.47	18.29 ± 4.09^*	18.33 ± 4.29	32.56 ± 6.34^*	0.55 ± 0.14	1.78 ± 0.32^*
t值	0.324	10.972	0.242	10.299	1.256	23.275
P值	0.460	0.000	0.809	0.000	0.210	0.000

组别	MUC5AC/（ng/mL）		8-OHdG/（ng/mL）		SOD/（U/mL）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 135）	156.71 ± 28.72	99.48 ± 17.03^*	3.44 ± 0.75	2.36 ± 0.54^*	56.54 ± 8.54	72.96 ± 11.23^*
观察组（n = 135）	159.90 ± 28.59	60.34 ± 15.49^*	3.54 ± 0.85	1.53 ± 0.41^*	56.72 ± 8.26	87.80 ± 11.92^*
t值	0.914	19.963	1.035	14.223	0.178	10.526
P值	0.361	0.000	0.301	0.00	0.859	0.000