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干扰素α1b 雾化治疗毛细支气管炎的多中心随机前瞻性研究。

A multi-center randomized prospective study on the treatment of infant bronchiolitis with interferon α1b nebulization.

机构信息

Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

出版信息

PLoS One. 2020 Feb 21;15(2):e0228391. doi: 10.1371/journal.pone.0228391. eCollection 2020.

Abstract

BACKGROUND

The respiratory syncytial virus (RSV) is the main cause of bronchiolitis in infants and interferon (IFN) α is a commercial antiviral drug. The nebulization of IFN α1b could be a viable treatment method. In this study, the therapeutic effects and safety of IFN α1b delivery via nebulization in infant bronchiolitis were investigated in this multi-center prospective study.

METHODS AND FINDINGS

Bronchiolitis patients admitted to 22 hospitals who met the inclusion criteria were enrolled and randomly allocated to four groups: control, IFN Intramuscular Injection, IFN Nebulization 1 (1 μg/kg), and IFN Nebulization 2 (2 μg/kg) groups. All patients were observed for 7 days. The therapeutic effects and safety of different IFN delivery doses and delivery modes were evaluated. Coughing severity change, as scored by the researchers and parents, between days 1 and 3 was significantly different between the IFN Nebulization 2 and control groups. Lowell wheezing score change between days 3 and 5 was significantly different between IFN Nebulization 1 and control groups. There were no significant differences among the four groups regarding the number of consecutive days with fever, three-concave sign, fatigue and sleepiness, and loss of appetite. There were no cases of severe complications, no recurrence of fever, and no regression of mental status.

CONCLUSIONS

IFN-α1b could more effectively alleviate coughing and wheezing in bronchiolitis. IFN-α1b nebulization had significant advantages in shortening the duration of wheezing and alleviating coughing.

摘要

背景

呼吸道合胞病毒(RSV)是婴儿毛细支气管炎的主要病因,干扰素(IFN)α 是一种商业抗病毒药物。IFNα1b 的雾化吸入可能是一种可行的治疗方法。本研究通过多中心前瞻性研究,探讨了 IFNα1b 雾化吸入治疗婴儿毛细支气管炎的疗效和安全性。

方法和发现

符合纳入标准的 22 家医院的毛细支气管炎患者被纳入并随机分为四组:对照组、IFN 肌肉注射组、IFN 雾化 1 组(1μg/kg)和 IFN 雾化 2 组(2μg/kg)。所有患者均观察 7 天。评估不同 IFN 给药剂量和给药方式的治疗效果和安全性。研究者和家长评分的咳嗽严重程度变化在 IFN 雾化 2 组和对照组之间在第 1 天和第 3 天之间有显著差异。IFN 雾化 1 组和对照组之间在第 3 天和第 5 天之间的 Lowell 喘鸣评分变化有显著差异。在连续发热天数、三凹征、疲劳和嗜睡、食欲不振等方面,四组之间无显著差异。无严重并发症、无发热复发、无精神状态恶化病例。

结论

IFN-α1b 能更有效地缓解毛细支气管炎的咳嗽和喘息。IFN-α1b 雾化吸入在缩短喘息持续时间和缓解咳嗽方面具有显著优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1181/7034796/1c424641c3f7/pone.0228391.g001.jpg

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