目的布地奈德(普米克令舒)联合沙丁胺醇雾化吸入治疗儿童哮喘急性发作前后气道炎性细胞、白介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)的变化,探讨其影响机制。方法对急性哮喘发作患儿采用上述联合治疗1周,共对34例急性发作期、24例缓解期患儿和15例正常儿童的诱导痰液进行炎性细胞计数和分类,测定其中IL-6、IL-8、TNF-α水平。结果急性组的总白细胞数,嗜酸粒细胞、中性粒细胞单核细胞比例及IL-6、IL-8、TNF-α水平均高于正常对照组。缓解组除嗜酸粒细胞及淋巴细胞比例明显高于正常对照组外,其余上述炎性细胞比例及细胞因子水平均降至正常。结论普米克令舒联合沙丁胺醇雾化吸入可显著降低急性哮喘发作患儿气道分泌物内嗜酸粒细胞、中性粒细胞和单核细胞数量及IL-6、IL-8、TNF-α水平。 Objective To investigate the changes of inflammatory cells, interleukin 6 (IL-6), interleukin-8 and tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid before and after budesonide , Explore its impact mechanism. Methods Acute asthmatic children were treated with the above combination therapy for 1 week. Inflammatory sputum samples from 34 acute exacerbation, 24 remission children and 15 normal children were collected for inflammatory cell counting and classification. IL-6 , IL-8, TNF-α levels. Results The total number of leukocytes, eosinophils, neutrophilic mononuclear cells and the levels of IL-6, IL-8 and TNF-α in the acute group were higher than those in the normal control group. The proportion of eosinophils and lymphocytes in the remission group was significantly higher than that in the normal control group, while the proportion of other inflammatory cells and the levels of cytokines in the remission group were all reduced to normal. Conclusions Pulmicort respules combined with albuterol inhalation can significantly reduce the levels of eosinophils, neutrophils and monocytes and the levels of IL-6, IL-8 and TNF-α in airway secretions of children with acute asthma attack .