孟鲁司特联合西替利嗪治疗小儿变应性鼻炎的临床疗效及细胞因子水平的影响

Study of the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum cytokines

目的探讨孟鲁司特钠联合西替利嗪对小儿变应性鼻炎血清干扰素γ（interferon-gamma,IFN-γ）和白细胞介素4（interleukin-1,IL-4）水平的影响及临床疗效。方法60例患儿随机分为治疗组与对照组各30例,对照组用盐酸西替利嗪滴剂,2-6岁5 mg/次,〉6岁10 mg/次,1次/d,口服。治疗组在对照组基础上联合孟魯司特钠,2-5岁4 mg,6-12岁5 mg,〉12岁10 mg,每晚睡前口服。4周为1个疗程,并设30例为健康组。结果两组治疗前与健康组比IFN-γ明显降低,IL-4明显增高（F分别为19.25、143.81,P〈0.01）;治疗后相反,IFN-γ均升高,IL-4均降低（F分别为6.29、117.22,P〈0.01）;LSD组间比较显示,与对照组相比,治疗组IFN-γ与IL-4水平在治疗前两组的差异无统计学意义（P〉0.05）,而治疗后则分别显著增高与降低,差异有统计学意义（P〈0.01）。临床疗效：VAS评分均比治疗前降低,但治疗组更低（P〈0.01）;治疗后与对照组比较,差异有显著性（P〈0.01）;两组随访1个月时与治疗结束时比较,差异无显著性（P〉0.05）。结论孟鲁司特钠联合西替利嗪治疗小儿变应性鼻炎有明显的临床疗效,其作用机制可能与纠正紊乱的IFN-γ与IL-4有关。

OBJECTIVE To study the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum IFN-γand IL-4.METHODS Sixty allergic rhinitis children were randomly divided into treatment group（30 children） and control group（30 children）.The control group were treated with cetirizine drops（po,ages 2-6,5 mg,qd,ages 〉6,10 mg,qd.）.Treatment group were treated with cetirizine drops combined with Montelucast（po,ages 2-5,4 mg,qn,ages 6-12,5 mg,qn,ages 〉12,10 mg.）.Thirty health children were selected as health group.RESULTS Before treatment,the level of serum IFN-γ in treatment group and control group were significantly lower than that in health group（P〈0.01）,but the level of serum IL-4 were significantly higher than that in health group（the F was 19.25 and 143.81 respectively;P〈0.01）.Before treatment,there was no significant difference in the level of serum IFN-γ and IL-4 between treatment and control group（P〉0.05）.After treatment,the level of serum IFN-γ of both groups increased,and the level of serum IL-4 of both groups decreased.However,the level of serum IL-4 and IFN-γ in treatment group changed significantly（P〈0.01）.After treatment,VAS scores were lower than that of before treatment,however that of the treatment group was the lowest（P〈0.01）.After one month follow-up,there was no significant difference between the two groups.CONCLUSION The mechanism of Montelucast and cetirizine on treatment of allergic rhinitis may be related to the correction of the disorder of IFN-γ and IL-4.