孟鲁司特钠对儿童哮喘血和痰液嗜酸细胞阳离子蛋白及白细胞介素5的影响

Effect of montelukast Na on serum and sputum eosinophil cationic protein and interleukin-5 in children with asthma

目的探讨孟鲁司特钠(顺尔宁)对儿童哮喘血和痰液嗜酸细胞阳离子蛋白(ECP)及白细胞介素5(IL 5)的影响.方法将60例6～14岁的中度哮喘儿童随机分为A组和B组,A组每日1次口服5 mg顺尔宁,B组吸入布地奈德(普米克都保)100 μg,每日2次,两组均持续治疗12周;于治疗前和治疗后第12周临床评估和肺功能检查,同步血嗜酸性粒细胞(Eos)计数和检测血和痰液ECP和IL 5水平.结果哮喘患儿治疗后临床症状和肺功能明显改善;治疗前哮喘患儿血ECP、IL 5水平和Eos计数均高于正常儿童对照组(P＜0.01);血Eos计数与血ECP浓度存在显著正相关(P＜0.01);血IL 5水平与ECP浓度呈显著正相关(P＜0.01);治疗后血ECP、IL 5水平和Eos计数较治疗前降低,差异有统计学意义(P＜0.01);痰液ECP和IL 5含量低于治疗前,差异有统计学意义(P＜0.01).结论顺尔宁降低血和痰液的ECP和IL 5水平,在哮喘的抗炎机制中起重要用.

Objective To investigate the effect of montelukast Na on serum and sputum eosinophil cationic protein (ECP) and interleukin-5(IL-5) in children with asthma.Methods Sixty children with moderate asthma aged 6-14 years old were randomly assigned to group A,taking 5 mg once daily orally montelukast Na,and group B,inhaling 100 μg twice daily budesonide,both groups were treated for 12 weeks.Forty-five normal children from body check served as normal control group.Before starting therapy and 12 weeks′ later,clinical effects were observed,and lung function was measured in the patients simultaneously; concentrations of serum and sputum ECP and IL-5 were measured respectively; also blood eosinophil (Eos) was counted.Results After 12 weeks′ treatment,therapy effect and lung function were improved in asthmatic children.Increased amounts of serum ECP,IL-5,and blood Eos counting were shown in the patients′ group compared with those in normal control group(P< 0.01); The blood Eos counting was significantly correlated with ECP concentration in serum of the patients with asthma (P< 0.01),the level of IL-5 was also significantly correlated with ECP concentration (P< 0.01).There was significant decrease in serum ECP,IL-5 and blood Eos counting in asthmatic children after treatment (P< 0.01).There was significant decrease in sputum ECP and IL-5 in the patients′ group after treatment compared with the same group before treatment.Conclusion Montelukast Na can lower the level of ECP and IL-5 in serum and sputum of asthmatic patients,which plays an important role for antagonizing airway inflammation of asthma.