摘要
目的探讨孟鲁司特钠联合糖皮质激素治疗小儿支气管哮喘(哮喘)急性发作的疗效及对细胞因子和免疫功能的影响。方法选择浙江新安国际医院2018年9月至2019年9月收治的小儿哮喘急性发作患儿122例,采用随机数字表法分为观察组61例与对照组61例。对照组患儿给予糖皮质激素治疗,观察组在对照组基础上联合孟鲁司特钠治疗。两组疗程均为7 d。比较两组疗效,治疗前后肺功能、细胞因子和免疫功能变化。结果观察组总有效率(91.80%)高于对照组(73.77%)(χ^2=6.960,P<0.05)。观察组治疗后峰值呼气流速(PEFR)[(2.93±0.21)L/s]、第1秒用力呼气容积占预计值百分比(FEV1%)[(82.54±5.37)%]和第1秒用力呼气容积/用力肺活量(FEV1/FVC)[(90.32±4.36)%]高于对照组[(2.48±0.16)L/s、(75.42±3.28)%和(83.98±3.42)%](t=13.313、8.837、8.936,均P<0.05)。观察组治疗后血清血管内皮生长因子(VEGF)[(129.83±17.64)ng/L]、转化生长因子β1(TGF-β1)[(83.21±16.79)ng/L]和白细胞介素6(IL-6)[(24.32±4.19)ng/L]低于对照组[(210.37±25.43)ng/L、(176.48±23.12)ng/L和(48.39±5.47)ng/L](t=20.325、25.494、27.284,均P<0.05)。观察组治疗后CD^+3[(75.72±3.46)%]、CD^+4[(42.56±3.18)%]和CD^+4/CD^+8(1.97±0.19)高于对照组[(66.81±4.80)%、(37.87±2.63)%和(1.62±0.16)](t=11.761、8.877、11.005,均P<0.05)。结论孟鲁司特钠联合糖皮质激素对哮喘急性发作患儿疗效明显,可减轻炎性反应,增强免疫功能,值得临床借鉴。
Objective To investigate the effect of montelukast sodium combined with glucocorticoid on acute attack of children with bronchial asthma and its influence on cytokines and immune function.Methods A total of 122 children with acute asthma attack admitted to Xin'an International Hospital from September 2018 to September 2019 were divided into observation group(61 cases)and control group(61 cases)according to the random digial table mrethod.The control group was treated with glucocorticoid,and the observation group was treated with montelukast sodium on the basis of the control group.The course of treatment in both two groups was 7 days.The therapeutic effect,lung function,cytokines and immune function of the two groups were compared before and after treatment.Results The total effective rate of the observation group(91.80%)was higher than 73.77%of the control group(χ^2=6.960,P<0.05).The peak expiratory flow rate(PEFR)[(2.93±0.21)L/s],forced expiratory volume in the first second(FEV1%)[(82.54±5.37)%]and forced expiratory volume/forced vital capacity in the first second(FEV1/FVC)[(90.32±4.36)%]in the observation group were higher than those in the control group[(2.48±0.16)L/s,(75.42±3.28)%and(83.98±3.42)%](t=13.313,8.837,8.936,all P<0.05).The levels of VEGF[(129.83±17.64)ng/L],TGF-β1[(83.21±16.79)ng/L]and IL-6[(24.32±4.19)ng/L]in the observation group were lower than those in the control group[(210.37±25.43)ng/L,(176.48±23.12)ng/L and(48.39±5.47)ng/L](t=20.325,25.494,27.284,all P<0.05).The CD^+3[(75.72±3.46)%],CD^+4[(42.56±3.18)%]and CD^+4/CD^+8(1.97±0.19)in the observation group were higher than those in the control group[(66.81±4.80)%,(37.87±2.63)%and(1.62±0.16)](t=11.761,8.877,11.005,all P<0.05).Conclusion Montelukast sodium combined with glucocorticoid has obvious therapeutic effect on children with acute attack of asthma.It can reduce inflammatory reaction and enhance immune function,which is worthy of clinical reference.
作者
张建婷
孙亚锋
何增洪
Zhang Jianting;Sun Yafeng;He Zenghong(Department of Pediatrics,Zhejiang Xin'an International Hospital,Jiaxing,Zhejiang 314000,China)
出处
《中国基层医药》
CAS
2020年第22期2725-2729,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
孟鲁司特钠
糖皮质激素
小儿哮喘
急性发作
疗效
肺功能
细胞因子
免疫功能
Montelukast sodium
Glucocorticoid
Childhood asthma
Acute attack
Efficacy
Lung function
Cytokines
Immune function
