孟鲁司特钠对小于5岁咳嗽变异性哮喘患儿EOS及血清总IgE水平的影响

Effects of Montelukast on serum immunoglobulin E and eosinophils in children with cough variant asthma under 5 years old

目的观察孟鲁司特钠对<5岁咳嗽变异性哮喘患儿外周血嗜酸性粒细胞计数及血清总IgE水平变化的影响。方法将2011年l～12月我科门诊入选的67例咳嗽变异性哮喘患儿,随机分为两组,30例为对照组给予常规的治疗,而观察组37例则在常规治疗的基础上给予孟鲁司特钠治疗。治疗前后分别测定患儿外周血嗜酸性粒细胞计数及血清总IgE。结果对照组治疗前后外周血嗜酸性粒细胞计数分别为(0.91±0.35)×109/L、(0.74±0.21)×109/L;治疗组治疗前后血嗜酸性粒细胞计数分别为(0.79±0.14)×109/L、(0.42±0.07)×109/L,治疗前后比较差异有高度统计学意义(P<0.01);对照组治疗前后血清总IgE水平分别为(90.17±14.06)、(88.65±18.13)IU/mL;治疗组治疗前后血清总IgE水平分别为(89.34±10.24)、(86.32±7.19)IU/mL,治疗前后比较差异有高度统计学意义(P<0.01);治疗3个月后两组比较差异有高度统计学意义(P<0.01)。结论孟鲁司特钠疗效确切,依从性好,口服方便,可降低<5岁咳嗽变异性哮喘患儿的血清总IgE水平,通过了解观察外周血嗜酸性粒细胞计数、血清总IgE水平的变化对咳嗽变异性哮喘的诊断治疗具有重要的临床指导意义。

Objective To study the therapeutic effect of serum immunoglobulin E （IgE） and eosinophils （EOS） with Mon- telukast in children with cough variant asthma （CVA） under 5 years old. Methods 47 cases with cough variant asthma un- der 5 years old were divided into two groups at random. The control group were treated with routine therapy, the treatment group were treated with Montelukast based on routine therapy for 3 months. The IgE and EOS levels were determined be- fore after treatment. Results Total effective rates in the treatment group and the control group were 78.37% and 43.33% respectively. The therapeutic efficacy in treatment group was significantly higher that in control group. Before and after treatment for 3 months, the EOS of control group were （0.91±0.35）×109/L and （0.74±0.21）xlO9/L respectively, the treatment group were （0.79±0.14）×lO9/L and （0.42±0.07）×lO9/L respectively. There was significant difference in EOS after treatment （P 〈 0.01）. Before and after treatment for 3 months, the serum total IgE of control group was （90.17±14.06） IU/mL and （88.65±18.13） IU/mL respectively. As to the treatment group, the serum total IgE before and after treatment for 3 months was （89.34±10.24） IU/mL and （86.32±7.19） IU/mL respectively. There was significant difference in total IgE before and af- ter treatment for 3 months （P 〈 0.01）. Conclusion Taking oral Montelukast to treat the cough variant asthma has the defi- nite curative effect, when treatment of children with cough variant asthma under 5 years old, Montelukast can decrease serum total IgE. Detection of IgE and EOS can be of great importance in diagnosis and treatment of children with cough variant asthma under 5 years old.