摘要
目的 探讨变应性鼻炎患者血清Th1/Th2细胞因子水平的变化及孟鲁司特的干预作用.方法 选择变应性鼻炎患者40例（治疗组）予以孟鲁司特片10 mg口服,1次/d,连用8周.观察患者治疗前后外周血中γ-干扰素（IFN-γ）和白介素-4（IL-4）水平的变化,并进行临床疗效及安全性的观察.另选择同期体检的正常健康者30例作为对照组.结果 治疗组患者治疗前培养上清中IFN-γ水平[（8.74±1.37） ng/mL]明显低于对照组[（15.13 ±3.16） ng/mL],IL-4水平[（1.64±0.47）ng/mL]明显高于对照组[（0.72±0.21） ng/mL]（t=2.93、3.52,均P＜0.01）.治疗8周后,患者培养上清中IFN-γ水平[（12.36±2.56） ng/mL]均较治疗前[（8.74±1.37） ng/mL]明显上升,IL-4水平[（1.21±0.28） ng/mL]均较治疗前[（1.64±0.47） ng/mL]明显下降（t=2.36、2.31,均P＜0.05）;且治疗组治疗8周后,临床总有效率92.5％ （37/40）,治疗期间未发生严重的药物不良反应.结论 变应性鼻炎患者存在外周血Th1/Th2细胞因子的失衡.孟鲁司特治疗变应性鼻炎的疗效确切,安全性较好,作用机制与其能降低外周血IL-4水平,提高外周血IFN-γ水平,纠正Th1/Th2细胞因子的平衡紊乱,使免疫反应由Th2型向Th1型转变密切相关.
Objective To discuss the changes of serum Th1/Th2 cytokine levels of allergic rhinitis patients and the intervention effect of montelukast.Methods 40 cases of allergic rhinitis patients were selected as treatment group,who were given montelukast tablets （10mg） through the mouth one time daily for 8 weeks.The changes of interferon-γ （IFN-γ） and interleukin-4 （IL-4） in peripheral blood （PB） before and after medical treatment were observed,as well as the clinical curative effect and security.Accordingly 30 cases of healthy people were also selected as the control group.Results The IFN-γlevel in culture supernatant of patients in the treatment group [（8.74 ± 1.37） ng/mL] was lower than that in the control group before the medical treatment [（15.13 ± 3.16）ng/mL],while the IL-4 level of patients in the treatment group [（1.64 ± 0.47） ng/mL] was higher than that in the control group [（0.72 ± 0.21） ng/mL] （t =2..93,3.52,all P ＜ 0.01）.After 8 weeks＇ medical treatment,the IFN-γ level in culture supernatant of patients [（12.36 ± 2.56） ng/mL] increased obviously than that of before [（8.74 ± 1.37） ng/mL],while the IL-4 level [（1.21 ± 0.28） ng/mL] declined obviously than that of before [（1.64 ± 0.47） ng/mL] （t =2.36,2.31,all P ＜ 0.05）.The total clinical efficiency of patients in the treatment group was 92.5 ％ （37/40）.No serious drug adverse reaction （DAR） appeared during the medical treatment.Conclusion The Th1/Th2 cytokine unbalances in peripheral blood （PB） of allergic rhinitis patients.Montelukast has reliable curative effect with high security,whose mechanism of action has close effect on lowering the IL-4 in peripheral blood （PB）,increasing the IFN-γ level in peripheral blood （PB）,correcting the balance disorders of Th1/Th2 cytokine,and the transformation of immunity reaction from Th2 to Th1.
出处
《中国基层医药》
CAS
2014年第18期2751-2753,共3页
Chinese Journal of Primary Medicine and Pharmacy
