孟鲁司特对变应性鼻炎患者外周血Th1/Th2细胞功能平衡的调节作用研究

Montelukast for Regulating the Balance on Peripheral Blood Th1/Th2 Cells in Patients with Allergic Rhinitis

目的观察孟鲁司特治疗变应性鼻炎的临床疗效,以及对外周血Th1/Th2细胞功能平衡的调节作用的影响,从而进一步研究其治疗变应性鼻炎的免疫机制。方法 92例变应性鼻炎患者根据治疗方法的不同随机分为孟鲁司特组和布地奈德组各46例,另选同期的健康体检者30例作为正常对照组,采用ELISA测定血清IFN-γ、IL-4的含量。结果孟鲁司特组的疗效明显优于对照组(P<0.05)。两组治疗后的的临床症状如鼻塞、鼻痒、流涕、喷嚏和体征评分均较治疗前明显降低,且孟鲁司特组改善明显优于布地奈德组(P<0.05)。孟鲁司特组、布地奈德组两组患者治疗前IL-4水平明显高于正常对照组,血清IFN-γ水平明显低于正常对照组(P<0.05)。治疗后孟鲁司特组血清中IL-4较治疗前有明显下降(P<0.01),IFN-γ较治疗前明显增高(P<0.05)。与布地奈德组比较,孟鲁司特组的IL-4、IFN-γ、IFN-γ/IL-4比值更接近正常对照组。结论孟鲁司特治疗变应性鼻炎疗效优于布地奈德,可能与其对变应性鼻炎患者Th1/Th2细胞功能平衡紊乱有一定的调节作用有关。

Objective To explore the clinical efficacy of Montelukast treating the allergic rhinitis, and further to explore the impact on regulating peripheral blood Thl/Th2 cell balance function, and further to study the immune mechanism of Montelukast treating allergic rhinitis. Methods 92 patients with allergic rhinitis were randomly divided into budesonide group and the budesonide group resepectively 46 cases. And at the same period to choose 30 cases healthy subjects as normal control group, using ELISA to check the serum IFN-γ, IL-4 levels. Results The efficacy of montelukast group was significantly better than the control group （ P 〈 0.05 ）. After treatment, the clinical symptoms such as nasal congestion, nasal itching, runny nose, sneezing, and symptoms score significantly was lower than before treatment, and the montelukast group improved significantly better than the budesonide group （ P 〈 0.05 ） .IL-4 in patients with allergic rhinitis were significantly higher than the normal control group, and the serum IFN- γ levels were significantly lower than the normal control group （P 〈 0.05 ）. After the treatment, the serum IL-4 levels in montelukast group compared with before treatment significantly decreased （P 〈 0.01 ）, IFN- γ significantly increased （P 〈 0.05 ）, and the serum IL-4, IFN- γ levels of montelukast group change than the budesonide group was significantly （ P 〈 0.05 ）. Conclusion Montelukast superior to the budesonide of treating allergic rhinitis, and it can significantly improve the clinical symptoms. It may be related to regulating the balance of Thl/Th2 cell function disorder in patients with allergic rhinitis.