%0 Journal Article
%T 参附注射液联合阿奇霉素治疗小儿支原体肺炎的临床疗效及机制<br>The clinical efficacy and mechanism of Shenfu injection combined with azithromycin on infantile mycoplasma pneumonia
%A 张 军
%A 封其华
%J 西安交通大学学报(医学版)
%D 2019
%R 10.7652/jdyxb201906033
%X 摘要：目的 探讨参附注射液联合阿奇霉素治疗小儿支原体肺炎的临床疗效及其可能的分子机制。方法 选取2016年6月－2017年6月苏州大学附属儿童医院风湿免疫科收治的支原体肺炎患儿按随机数字法分为两组，每组40例。两组均给予阿奇霉素治疗，观察组同时联合应用参附注射液，比较两组的临床疗效、免疫功能、miR-181a水平及相关分子指标变化情况。使用慢病毒将miR-181a转染入人T淋巴细胞中，观察其对淋巴细胞增殖、细胞因子分泌水平及相关信号通路的影响。结果 与对照组治疗后相比，观察组的治疗有效率、T细胞亚群比例、细胞因子水平均明显升高(P<0.05)，观察组患儿的临床症状缓解时间明显缩短(P<0.05)。治疗后，观察组淋巴细胞内miR-181a水平(9.3±5.3)明显低于对照组(12.2±4.5)(P<0.05)。体外实验显示转染miR-181a可降低淋巴细胞增殖及细胞因子白细胞介素-2(IL-2)、白细胞介素-22(IL-22)、干扰素-γ(IFN-γ)和肿瘤坏死因子-β(TNF-β)的分泌；miR-181a转染组KRAS、NRAS和MAPK1的mRNA表达降低，并且P-AKT和P-MEK的磷酸化水平降低。结论 参附注射液联合阿奇霉素可通过改善患儿免疫功能提高治疗有效率，其机制可能与降低淋巴细胞中miR-181a水平有关。<br>ABSTRACT: Objective To evaluate the clinical efficacy and molecular mechanism of Shenfu combined with azithromycin on infantile mycoplasma pneumonia. Methods Totally 80 children with mycoplasma pneumonia treated in Children’s Hospital Affiliated to Soochow University from June 2016 to June 2017 were selected and randomly divided into two groups with 40 in each. Azithromycin was provided in both groups. Shenfu was administered in the observation group. The clinical efficacy, immunological functions and miR-181a level, and related molecular markers of all the subjects were observed. Lentivirus was used to transfer miR-181a into human T lymphocytes to observe its effects on lymphocyte proliferation, cytokine secretion level and related signaling pathways. Results Compared with the normal group after treatment, the clinical efficacy, T lymphocyte subset proportion and inflammation cytokines were significantly increased (P<0.05), and the time of clinical symptoms remission was significantly decreased in the observation group after treatment (P<0.05). In addition, the content of miR-181a (9.3±5.3) in lymphocytes of the observation group after treatment was significantly lower than that (12.2±4.5) of the control group after treatment (P<0.05). In vitro assay revealed that miR-181a was significantly decreased lymphocyte proliferation and the ability of secretory cytokine. Luciferase reporter assay demonstrated that miR-181a could inhibit KRAS, NRAS and MAPK1 expressions, thus down-regulating P-AKT and P-MEK phosphorylation. Conclusion Shenfu combined with azithromycin can effectively improve immunity functions and its mechanism might be related to the level of miR-181a in lymphocytes
%K 参附注射液
%K 阿奇霉素
%K 小儿支原体肺炎
%K T细胞亚群
%K miR-181a<br>Shenfu injection
%K Azithromycin
%K infantile mycoplasma pneumonia
%K T cell subset
%K miR-181a
%U http://yxxb.xjtu.edu.cn//oa/darticle.aspx?type=view&id=201906033