孟鲁司特钠对过敏性紫癜患儿体内血清IL-4及可溶性细胞间粘附因子-1水平的影响

Effect of montelukast on the serum IL-4 and soluble intercellular adhesion factor-1 levels of children with allergic purpura

目的探讨孟鲁司特钠对过敏性紫癜患儿血清中白细胞介素-4(IL-4)及可溶性细胞间粘附因子-1(s ICAM-1)水平的影响。方法应用随机数字表法将50例过敏性紫癜患儿分为孟鲁司特钠治疗组(观察组,26例)及常规治疗组(对照组,24例)。观察两组的治疗效果、临床症状缓解情况与不良反应情况,检测两组患者治疗前后的血清IL-4、s ICAM-1水平。结果治疗后,观察组的总有效率(96.2%)明显高于对照组(79.2%),两组比较差异有统计学意义(P<0.05)。观察组的皮肤紫癜、关节疼痛、腹痛与蛋白尿等消失时间明显短于对照组(P<0.05)。治疗后,两组血清IL-4、s ICAM-1表达均下降(P<0.05),且观察组低于对照组(P<0.05)。对照组未出现不良反应,观察组有1例患儿出现心悸,对症处理后好转,两组比较差异无统计学意义(P>0.05)。结论孟鲁司特钠治疗过敏性紫癜患儿能有效抑制机体血清IL-4与s ICAM-1表达,促进临床症状的缓解,安全性较好。

Objective To investigate the effect of montelukast on IL-4 and soluble intercellular adhesion factor-1（ s ICAM-1） in serumof children with allergic purpura. Methods Fifty children with allergic purpura were divided into montelukast sodiumtreatment group（ observation group,n = 26） and routine treatment group（ control group,n = 24） using the method of randomnumber table. The therapeutic effect,clinical symptoms and adverse drug reactions of the two groups were observed,and the serumlevels of IL-4 and s ICAM-1 were detected before and after treatment. Results The total effective rate of observation group was higher than that of control group（ 96. 2% vs. 79. 2%,P〈0. 05）. The disappearance time of the skin purpura,joint pain,abdominal pain and proteinuria in observation group was less than that of control group（ P 〈0. 05）. The serumIL-4 and s ICAM-1 expression decreased significantly after treatment（ P〉0. 05）,and the levels of observation group were lower than those of control group（ P〈0. 05）. There was no adverse reaction in control group,while there was a case of heart palpitation whose symptoms were improved after symptomatic treatment in observation group. No significant difference was observed between the two groups in the rate of adverse reaction（ P〈0. 05）. Conclusion Montelukast sodiumin the treatment of children with allergic purpura can effectively inhibit the expression of serumIL-4 and s ICAM-1,promote the relief of clinical symptoms with good security.