孟鲁司特钠联合特布他林对变异性哮喘患儿肺功能及细胞免疫功能的影响

Effects of montelukast combined with terbutaline on lung function and cellular immune function in children with cough variant asthma

目的观察孟鲁司特钠联合特布他林在咳嗽变异性哮喘(cough variant asthma,CVA)患儿中的临床应用,分析患儿肺功能、炎性细胞因子和T淋巴细胞亚群水平的变化。方法将收治的90例CVA患儿按照抽签法随机分为对照组45例和观察组45例,两组均行常规治疗。在此基础上,对照组给予特布他林雾化液治疗,观察组在对照组的基础上,给予孟鲁司特钠咀嚼片治疗。检测所有受试者肺功能、血清炎性细胞因子和T淋巴细胞亚群水平。结果治疗后,两组FEV1和PEF水平较治疗前均明显升高(P<0.05);且观察组高于对照组(P<0.05);两组治疗前后FVC水平组内和组间比较,差异均无统计学意义(P>0.05)。治疗后,两组血清TNF-α和IL-6水平较治疗前明显降低(P<0.05);且观察组低于对照组(P<0.05)。治疗后,两组CD+4和CD+4/CD+8水平较治疗前明显升高(P<0.05);且观察组高于对照组(P<0.05)。治疗后,两组CD+8水平均较治疗前明显降低(P<0.05),且观察组低于对照组(P<0.05)。结论孟鲁司特钠联合特布他林治疗CVA患儿,能更有效提高患儿肺功能、抑制气道局部炎症反应、提高T淋巴细胞亚群水平,、促进患儿免疫功能恢复,是临床潜在的有效方案之一。

Objective To observe the clinical application of montelukast sodium combined with terbutaline in cough variant asthma（CVA）children and analyze the level of pulmonary function,inflammatory factor and T lymphocyte subsets.Methods 90 patients with CVA were randomly divided into control group（n=45）and observation group（n=45）according to the lottery method.Both groups were treated with routine therapy.On this basis,the control group was given terbutaline atomization solution.The observation group was given montelukast sodium chewable tablet on the basis of the control group.The levels of pulmonary function,serum inflammatory factors and T lymphocyte subsets were measured in all subjects.Results There was no significant difference in lung function between the two groups before treatment（P〉0.05）.After treatment,the levels of FEV1 and PEF in both groups were significantly higher than those before treatment（P〈0.05）.The observation group was significantly higher than the control group,and the difference was significant（P〈0.05）.There was no significant difference in FVC level between the two groups before and after treatment（P〈0.05）.There was no significant difference in the level of inflammatory factors between the two groups before treatment（P〉0.05）.After treatment,the levels of serum TNF-αand IL-6 in the two groups were significantly lower than those before treatment（P〈0.05）.The observation group was significantly lower than the control group,and the difference was significant（P〈0.05）.There was no significant difference in T lymphocyte subsets between the two groups before treatment（P〉0.05）.After treatment,the levels of CD4^＋ and CD4^＋ ♂/CD8^＋ ♂in the two groups were significantly higher than those before treatment（P〈0.05）.The observation group was significantly higher than the control group,and the difference was significant（P〈0.05）.After treatment,the levels of CD8^＋ ♂ in the two groups were significantly lower than those before treatment（P〈0.05）.The observation group was significantly lower than the control group,and the difference was significant（P〈0.05）.Conclusion The combination of montelukast sodium combined with terbutaline in the treatment of children with CVA can improve the pulmonary function,inhibit the inflammation of the airway,increase the level of T lymphocyte subsets and promote the recovery of immune function.