孟鲁司特联合雾化吸入布地奈德治疗小儿哮喘急性发作的疗效及对患儿血清炎性因子的影响

Efficacy of Montelukast Combined with Budesonide for Inhalation in Treatment of Acute Asthma in Children and its Effects on Serum Inflammatory Factors

目的:探讨孟鲁司特联合雾化吸入布地奈德治疗小儿哮喘急性发作的疗效及对患儿血清炎性因子的影响。方法:选取2015年1月至2018年1月开封市儿童医院收治的140例小儿哮喘急性发作患儿作为研究对象,按照随机数字表法分为观察组和对照组,每组70例。对照组患儿给予布地奈德雾化吸入治疗,观察组患儿在对照组的基础上联合孟鲁司特治疗。比较两组患儿的临床疗效、症状评分、肺功能指标水平[1 s用力呼气容积(FEV_1)、用力肺活量(FVC)和1 s用力呼气容积占用力肺活量百分比(FEV_1/FVC)]、免疫功能指标水平及血清炎性因子水平[嗜酸性粒细胞阳离子蛋白(ECP)、白细胞介素6(IL-6)、白细胞介素8(IL-8)及白细胞介素10(IL-10)]的差异。结果:观察组患儿的总有效率为94.3%(66/70),明显高于对照组的81.4%(57/70),差异有统计学意义(P<0.05);治疗后,观察组患儿日间、夜间症状评分明显低于对照组,FEV_1、FVC和FEV_1/FVC水平明显高于对照组,差异均有统计学意义(P<0.05);观察组患儿CD8^+水平明显高于对照组,CD4^+、CD4^+/CD8^+水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患儿血清ECP、IL-6及IL-8水平明显低于对照组,血清IL-10水平明显高于对照组,差异均有统计学意义(P<0.05)。结论:孟鲁司特联合雾化吸入布地奈德治疗小儿哮喘急性发作的疗效理想,可有效改善患儿的肺功能、免疫功能及血清炎性因子水平。

OBJECTIVE:To probe into the efficacy of montelukast combined with budesonide for inhalation in treatment of acute asthma in children and its effects on serum inflammatory factors.METHODS:140 children with acute asthma attacks in Kaifeng Children's Hospital from Jan.2015 to Jan.2018 were selected and divided into observation group and control group via random number table,with 70 cases in each.The control group was given budesonide for inhalation,while the observation group was treated with montelukast based on the control group.Differences in clinical efficacy,symptom scores,pulmonary function indices[forced expiratory volume in 1s(FEV 1),forced vital capacity(FVC)and FEV 1/FVC],immunological function indices and inflammatory factor levels[eosinophilic granulocyte(ECP),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10)]between two groups were compared.RESULTS:The total effective rate of observation group was 94.3%(66/70),which was significantly higher than that of the control group(81.4%,57/70),with statistically significant difference(P<0.05);after treatment,the symptom scores in the daytime and nighttime of observation group were significantly lower than those of the control group,while the FEV 1,FVC and FEV 1/FVC levels of observation group were significantly higher,with statistically significant differences(P<0.05);the CD8+level of observation group was significantly higher than that of the control group,while the CD4+and CD4+/CD8+levels of observation group were significantly lower,with statistically significant differences(P<0.05);the ECP,IL-6 and IL-8 levels of observation group were significantly lower than those of the control group,while the IL-10 level of observation group was significantly higher,with statistically significant differences(P<0.05).CONCLUSIONS:The efficacy of montelukast combined with budesonide for inhalation in treatment of acute asthma in children is remarkable,which can effectively improve children's pulmonary function,immunological function and serum inflammatory factors.