孟鲁司特钠片联合糠酸氟替卡松治疗支气管哮喘患儿的疗效及对miRNA-21、miRNA-26a水平的影响

Effects of montelukast sodium tablets combined with fluticasone furoate in treating child bronchial asthma and its influence on miRNA-21 and miRNA-26a levels

目的探究孟鲁司特钠片联合糠酸氟替卡松治疗对支气管哮喘患儿血清微小RNA(miRNA)-21及miRNA-26a水平的影响。方法选择2020年3月至2022年3月陕西省人民医院儿童病院收治的支气管哮喘患儿120例,按照随机数字表法分为两组,每组60例。在常规方法的基础上,对照组使用布地奈德雾化吸入治疗,观察组使用孟鲁司特钠片联合糠酸氟替卡松治疗。比较两组治疗后临床疗效和不良反应。检测并比较两组患儿肺功能指标、血清炎症因子以及miRNA-21、miRNA-26a表达水平。结果治疗后两组第1秒用力呼气容积(FEV_(1))和最大呼气流量(PEF)均显著升高(P<0.05),且观察组FEV1和PEF均显著高于对照组(P<0.05)。治疗后两组超敏C感应蛋白(hs-CRP)和白细胞介素6(IL-6)水平均显著降低(P<0.05),且观察组hs-CPR和IL-6水平均显著低于对照组(P<0.05)。治疗后两组miRNA-21和miRNA-26a表达水平均显著降低(P<0.05),且观察组均显著低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论糠酸氟替卡松联合孟鲁斯特钠片对儿童支气管哮喘具有更好的临床疗效,可提高肺功能,并具有一定的安全性。并且联合治疗可能通过下调miRNA-21和miRNA-26a的表达水平抑制炎症因子。

Objective To investigate the effects of montelukast sodium tablets combined with fluticasone furoate on serum microRNA(miRNA)-21 and miRNA-26a levels in children patients with bronchial asthma.Methods A total of 120 children patients with bronchial asthma in Children′s Hospital of Shaanxi Provincial People′s Hospital from March 2020 to March 2022 were selected and divided into the two groups according to the random number table method.On the basis of conventional treatment,the control group was treated with desonide atomization inhalation,and the observation group used montelukast sodium tablets combined with fluticasone furoate.The clinical efficacy and adverse reactions after treatment were compared between the two groups.The lung function indexes,serum inflammatory factors,and miRNA-21 and miRNA-26a expression levels were measured and compared between the two groups.Results After treatment,the FEV 1 and PEF levels were significantly increased(P<0.05),FEV_(1) and PEF after treatment in the observation group were significantly higher than those in the control group(P<0.05).The levels of hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)after treatment were significantly decreased(P<0.05).The hs-CPR and IL-6 levels after treatment in the observation group were significantly lower than those in the control group(P<0.05).The miRNA-21 and miRNA-26a expression levels after treatment in the two groups were significantly decreased(P<0.05),moreover the observation group were significantly lower than the control group(P<0.05).The total incidence rate of adverse reactions showed no statistical difference between the two groups(P>0.05).Conclusion Fluticasone furoate combined with montelukast sodium tablets has a better clinical effect in children patients with bronchial asthma,improves the lung function,and has certain safety.And their combination therapy may inhibit the inflammatory factor levels by down-regulating the expression levels of miRNA-21 and miRNA-26a.