孟鲁司特钠联合布地奈德气雾剂对小儿咳嗽变异性哮喘患者血清IgE、IL-4和TNF-α水平的影响

Influence of montelukast combined with budesonide on serum IgE、IL-4 and TNF-αlevels in children with cough variant asthma

目的:观察孟鲁司特钠联合布地奈德气雾剂对小儿咳嗽变异性哮喘(CVA)患者血清IgE、白介素-4(IL-4)和肿瘤坏死因子-α(TNF-α)水平的影响。方法:将80例小儿CVA患者随机分为对照组和研究组,每组40例,两组均吸入布地奈德气雾剂,研究组另行孟鲁司特钠治疗,治疗结束后,观察两组治疗前后肺活量(VC)、用力肺活量(FVC)和第1秒钟用力呼气容积(FEV1)变化。采用ELISA法检测血清IgE、IL-4和TNF-α水平。结果:与治疗前比较,两组治疗后血清IgE、IL-4和TNF-α水平显著降低,差异具有统计学意义(P<0.05);与对照组治疗后比较,研究组治疗后血清IgE、IL-4和TNF-α水平降低,差异具有统计学意义(P<0.05);治疗后两组FVC、FEV1与治疗前相比差异显著,与对照组治疗后比较,研究组治疗后FVC、FEV1改善更明显,差异均具有统计学意义(P<0.05);研究组治疗后血清IgE、IL-4和TNF-α水平与FVC、FEV1间呈正相关,差异均具有统计学意义(P<0.05)。结论:孟鲁司特钠联合布地奈德气雾剂对小儿CVA患者临床疗效显著,能有效干预血清炎性因子IgE、IL-4和TNF-α的释放,值得临床推广使用。

Objective. To observe the influence of montelukast combined with inhalation of budes onide on serum IgE,IL-4 and TNF-a levels in children with cough variant asthma. Methods; A total of 80 children with CVA were randomly divided into control group and research group, with 40 cases in each group; both groups were treated with inhalation of budesonide, research group were also given monte- lukast. VC,FVC and FEV1 were observed in both groups before and after treatment. Levels of the serum IgE, IL-4 and TNF-α Using were detected by ELISA method. Results. Serum IgE,IL-4 and TNF-α levels of two groups significantly reduced after treatment, the difference was statistically significant（P〈0.05）. After treatment, the serum IgE,IL-4 and TNF-α levels of the research group were significantly reduced comparing with the control group （P〈0.05）; FVC,FEV1 were significantly improved after treatment in both groups, but more obviously in the research group （P〈0.05） comparing with the control group after treatment. Serum IgE,IL 4 and TNF -α levels were significantly correlated with the FVC, FEV1 （P% 0.05）. Gonclusions. Montelukast combined with inhalation of budesonide have great clinical efficacy on CVA in children, it can effectively intervene the release of serum IgE,IL-4 and TNF -α levels, thus it＇s worthy of clinical application.