Exploration Of Azithromycin On Airway Inflammation After Bronchiolitis Infection

PARTⅠThe effect of azithromycin on the treatment of airway inflammation in infants with bronchiolitis after respiratory syncytial viruses infectionObjective:1.To explore the effect of azithromycin on the treatment of airway inflammation in infants with bronchiolitis after respiratory syncytial viruses(RSV)infection by detecting the serum concentration change of inflammatory cellular factors such as the eosinophil cationic protein(ECP),interleukin-8(IL-8)and nitrogen oxide(NO).2.To discuss the prevente of contribution of asthma after RSV infection by the treatmeant of azithromycin.Methods:163 cases of infants with bronchiolitis were randomly divided four groups after clinical symptom remission,azithromycin was given to the group A,inhaled budesonide to the group B,oral singulair to the group C,and blank control is the group D.Each of them was further divided two subgroup with or without eczema.The vein blood was sampled hospitalized immediately,before and after medication respectively.Serum concentration of ECP and IL-8 were obtained by ELISA methods.And NO were measured by nitric acid enzyme reduction method.Follow up clinic service and telephone analysis about one year. Analysis of all data was conduced with SPSS15.0 soft package.Results:1 The cases of asthma recurrence within 3 months and re-attack more than 3 times within 1 year in infants were decreased respectively than the group D.But there was no statistical difference in group A compared with group B,group C and group D despite of eczema.It was same to the cases of no eczema.2 There was statistically significant difference in the cases of asthma recurrence within 3 months and re-attack more than 3 times within 1 year in infants with eczema than without it.3 The serum concentration of ECP,IL-8 and NO were obviously decreased in remission stages compared with acute phases,but did not decrease to normal level.4 There was no significant difference about the serum concentration of ECP,IL-8 and NO before medical management in group A,group B and group C compared with group D and any two of treatment groups;Although the serum concentration of inflammatory cellular factors in mediation groups were decreased as well as control group, decrease was significant compared with control group D(P＜0.05);Serum concentration of ECP and NO of each group were decreased,especially in group C.Statistical difference was not obvious between group A and group B,but obvious between group A and group C; Serum concentration of IL-8 of each group were decreased,especially in group A. Statistical difference was obvious in group A compared with group B and group C.5 The serum concentration of ECP,IL-8 and NO was not significantly different before medical management in each group and analysis data was comparable;The serum concentration of inflammatory cellular factors were decreased in each group,and there was no statistical difference between group A and group B,group C,group D respectively.6 The serum concentration of ECP,IL-8 and NO with eczema were higher before azithromyein intervene than no eczema,ECP had statistical difference among them.IL-8 and NO decreased more significantly after managed treatment in infants with eczema than without it,but ECP was not.Conclusion:1.The inhabitant effects of azithromycin on change of ECP,NO and IL-8 was indicated in our experimental study.2.The inhabitant effects of azithromycin on change of ECP and NO were similar to the inhaled steroid hormone,but different with Leukotriene receptor.While the inhabitant effects of IL-8 was different with inhaled steroid hormone and Leukotriene receptor obviously.3.The incidence rate of repetatur gasp interfere in azithromycin had no diminished significantly after follow up one year. PARTⅡExploration of azithromycin on secondary prevention of asthmaObjective:1.To discuss the effect of azithromycin on the airway inflammation in infants children at high risk for asthma by detecting the serum concentration change of the eosinophil cationic protein(ECP),interleukin-8(IL-8)and nitrogen oxide(NO).2.To explore the effect of azithromycin on secondary prevention of asthma.Methods:142 cases of primary asthmatic attack with atoy(eczema,family asthmatic history) and without steroid hormone received were collected and divided four groups after asthmatic symptoms relief,oral azithromycin(5mg/kg Biw)was given to the group A, inhaled budesonide to the group B,oral singulair to the group C,and blank control is the group D.The vein bloods were sampled on the first day in hospital,before and after medication respectively when treatments of 3 months was completed.Serum concentration of ECP and IL-8 were obtained by ELISA methods.And NO were measured by nitric acid enzyme reduction method.Follow up clinic service and telephone analysis about one year. Analysis of all data was conduced with SPSS15.0 soft package.Results:1.The cases of asthma recurrence within 3 months and asthmatic recurrence within one year were decreased in intervened groups compared with the group D.But there was no statistical difference between group A and group B,group C and group D respectively.2.The serum concentration of ECP,IL-8 and NO in 142 subjects were obviously decreased in remission stages compared with acute phases,but did not decrease to normal level.3.There was no significant difference about the serum concentration of ECP,IL-8 and NO before medical management in group A,group B and group C compared with group D and any two of treatment groups;Although the serum concentration of inflammatory cellular factors in mediation groups were decreased as well as control group,decrease was statistically significant compared with control group D.There was no significant difference in decrease of ECP and NO of between group A and group B,but decrease of ECP and NO in group C was significant compared with group A.The serum concentration of IL-8 in each group was obviously decreased especially in group A.Statistical difference was obvious between group A and group B,group C.Conclusion:1.The medication of azithromycin might result to decrease the serum concentration of ECP and NO,especially for IL-8.2.The inhabitant effects of azithromycin on change of ECP and NO were similar to the inhaled steroid hormone(budesonide),but different with Leukotriene receptor (montelukast).While the inhabitant effects of IL-8 was different with inhaled steroid hormone and Leukotriene receptor obviously.3.It was no valid contribution of azithromycin act on the secondary prevention of asthma in our investigation.