孟鲁司特钠对支气管哮喘患儿Th17/Treg细胞平衡及肺功能的影响

The influence of montelukast on the balance of Th17/Treg and lung function of children with bronchial asthma

目的观察孟鲁司特钠对支气管哮喘患儿Th17/Treg细胞平衡及肺功能的影响。方法选取120例支气管哮喘患儿,随机分为实验组和对照组,每组60例。所有患儿给予丙酸氟替卡松等常规治疗,实验组加用孟鲁司特钠治疗。分别于治疗前和治疗3个月后检测和比较患儿的Th17、Treg细胞及其IL-17、IL-10和TGF-β1等细胞因子和肺功能。结果 (1)所有患儿治疗后Th17细胞及其分泌的IL-17水平和PEF肺功能指标均有显著下降,Treg细胞及其分泌的IL-10和TGF-β1水平和FEV1、FEV1/FCV肺功能指标均有显著升高(P<0.01)。且经过孟鲁司特钠治疗的实验组患儿的Th17细胞、IL-17水平和PEF的下降及Treg细胞、IL-10和TGF-β1水平、FEV1和FEV1/FCV的升高较对照组患儿更为明显(P<0.05或0.01)。(2)Th17细胞与Treg细胞呈负相关(P<0.05)。Th17细胞与FEV1、FEV1/FCV呈负相关,与PEF呈正相关;而Treg细胞与FEV1、FEV1/FCV呈正相关,与PEF呈负相关(P<0.05)。结论孟鲁司特钠可有效调节支气管哮喘患儿的Th17/Treg细胞平衡,改善其肺功能,且Th17/Treg细胞与肺功能存在相关性。

Objective To observe the influence of montelukast on the balance of Th17/Treg and lung function of children with bronchial asthma.Methods120children with bronchial asthma were selected and randomLy divided into the experimental group and the control group and60cases in each group.All patients were given fluticasone propionate and other conventional treatments.The patients in the experimental group were given montelukast additionally.Determine and compare the quantity of Th17and Treg cells,the level of IL-17,IL-10,TGF-β1and the lung function before treatment and3months later.Results(1)There are significant decline in the quantity of Th17cells,the level of IL-17and PEF,increase in the quantity of Treg cells,the level of IL-10,TGF-β1and FEV1,FEV1/FCV of all patients after treatment(P<0.01).It is significant higher in the quantity of Th17cells,the level of IL-17and PEF,lower in the quantity of Treg cells,the level of IL-10,TGF-β1and FEV1,FEV1/FCV of patients in the experimental group than in the control group after treatment of montelukast(P<0.05or0.01).(2)Th17cells are negatively related to Treg cells(P<0.05).Th17cells are negatively related to FEV1,FEV1/FCV and positively related to PEF(P<0.05).Treg cells are positively related to FEV1,FEV1/FCV and negatively related to PEF(P<0.05).Conclusion Montelukast can modulate the balance of Th17/Treg of children with bronchial asthma,and improve their lung function.There are correlation between Th17/Treg cells and lung function.