目的 探讨孟鲁司特治疗与预防儿童过敏性紫癜发作的疗效.方法 过敏性紫癜患儿60例,数字表法随机分为观察组和对照组.两组均常规予以葡萄糖酸钙、维生素C和双嘧达膜等基础治疗.观察组在此基础上加用孟鲁司特治疗,连用2周.观察并比较两组治疗后临床疗效及不良反应,随访观察患儿半年内的复发率.结果 治疗2周后,观察组的临床总有效率明显高于对照组(x2 =4.32,P＜0.01).观察组和对照组治疗期间出现不良反应分别为4例和2例.两组不良反应发生率差异无统计学意义(x2 =0.19,P＞0.05).观察组的复发率明显低于对照组(x2=3.95,P＜0.05).结论 孟鲁司特治疗和预防过敏性紫癜的复发疗效确切,能明显改善患儿的症状和体征,安全性较好.

目的观察匹多莫德治疗和预防儿童反复呼吸道感染发作的疗效。方法选择反复呼吸道感染儿童80例,随机分为观察组与对照组。两组患儿均常规予以抗感染对症治疗,观察组患儿在此基础上予以匹多莫德分散片0.4 g口服,每日1次,连用3个月。观察两组患儿治疗后主要症状及体征消退时间,并进行临床疗效及不良反应的观察。结果观察组患儿急性发作期发热、咳嗽咳痰和肺部罗音消失时间均明显短于对照组(P<0.05)。治疗后随访6个月,观察组临床总有效率明显高于对照组(χ2=8.54,P<0.01)。两组患儿治疗期间均未见明显的药品不良反应。结论匹多莫德治疗和预防儿童反复呼吸道感染的疗效确切,能明显缩短患儿急性发作期的病程,有效预防其复发,安全性较好。

【 Objective 】 To investigate the potential roles of tumor necrosis factor related apoptosis inducing ligand(TRAIL) and its soluble receptors(sTRAILR1and sTRAILR4) in the pathogenesis of respiratory tract infections,the concentrations of sTRAIL,sTRAILR1and sTRAILR4proteins were determined.【 Methods 】 Concentrations of sTRAIL and sTRAILR1and sTRAILR4protein were detected by ELISA,in patients with bronchiolitis and acute upper respiratory infection and individuals(named bronchiolitis group,AURI group,control group).【 Results 】 The concentrations of sTRAIL,sTRAILR1and sTRAILR4protein were significantly higher in bronchiolitis group(85±38),(71±19),(167±97) pg / mL,respectively and in AURI group(78±28),(61±15),(139±72) pg / mL than those in control group(55±19),(45±14),(56 ±38) pg / mL,respectively(Pall0.01).Data also showed that the concentration of sTRAILR1protein was markedly higher in bronchiolitis group than that in AURI group(P all0.05).While no significance were observed of sTRAIL and sTRAILR4expressions between the patients with bronchiolitis group and in AURI group(P0.05).Furthermore,levels of sTRAILR1was highly correlated to sTRAIL and sTRAILR4(n=102,r=0.236and 0.409respectively,all P0.01).【 Conclusion 】 Levels of sTRAIL,sTRAILR1and sTRAILR4were elevated in bronchiolitis and AURI which could be applied as an effective targets of patient's condition judgment.Our study indicated TRAIL and its receptors may involved in the pathogenesis of bronchiolitis and AURI inflammation.

OBJECTIVE To investigate the concentration of serum soluble Interleukin receptor(sIL-1RⅠ、sIL-2R、sIL-4R)protein in pediatric patients with bacterial pneumonia,and potential roles of them.METHODS All the patients were obtained during December 2008 to March 2009 including 37 cases of patients with bacterial pneumonia(26 of mild and 11of severe),and were compared to 22 cases of volunteers.Concentrations of sIL-1RⅠ,sIL-2R and sIL-4R were detected by enzyme linked immunosorbent assay methods(ELASA).And the Concentrations of IL-8 were also determined.RESULTS The concentrations of sIL-1RⅠ,sIL-2R,sIL-4R and IL-8 proteins were significantly higher from acute phase of bacterial pneumonia(39.62±11.91pg·mL-1,508±356 pg·mL-1,71.32±18.40 pg·mL-1,4.35±1.09ng·mL-1,respectively)than those in control group(13.04±2.48pg·mL-1,91±40 pg·mL-1,18.75±9.97pg·mL-1,1.48±0.54ng·mL-1,respectively)(all P0.01).Data also showed that the concentrations of them were markedly lower at recovery stage(21.08±5.57pg·mL-1,174±58pg·mL-1,25.86±9.97 pg·mL-1,1.85±0.69ng·mL-1,respectively)than those at acute phase(all P0.01).CONCLUSION Concentrations of sIL-1RⅠ,sIL-2R,sIL-4R and IL-8 were elevated at acut phase of bacterial pneumonia in pediatric patients.While they were decreased at convalescence stage.Our study indicated combination detection of serum sIL-1RⅠ,sIL-2R,sIL-4R and IL-8 levels are clinically useful in the management and evaluation of bacterial Pneumonia.