增用孟鲁司特钠对呼吸道合胞病毒致毛细支气管炎患儿CD3^+、CD4^+、CD8^+及SP、5-HT水平的影响

Effects of adding montelukast sodium on levels of CD3^+,CD4^+,CD8^+,SP and 5-HT in children patients with bronchiolitis caused by respiratory syncytial virus

目的研究增用孟鲁司特钠对呼吸道合胞病毒致毛细支气管炎患儿CD3^+、CD4^+、CD8^+及肺表面活性蛋白(SP)、5-羟色胺(5-HT)水平的影响。方法选取2015年3月至2016年8月于西安市儿童医院接受治疗的呼吸道合胞病毒致毛细支气管患儿100例。按照随机数字表法将其分为观察组与对照组,各50例。对照组予以常规综合治疗,观察组则在常规综合治疗的基础上增用孟鲁司特钠。比较两组临床指标,治疗前后CD3^+、CD4^+、CD8^+、SP、5-HT水平,患儿1年内喘息复发情况,不良反应发生情况。结果观察组咳嗽消失时间、喘息消失时间、氧疗时间以及住院时间明显短于对照组,差异均有统计学意义(P<0.05)。治疗后观察组CD3^+、CD4^+、CD4^+/CD8^+水平分别为(63.22±8.48)%、(34.72±7.07)%、1.72±0.45,均明显高于对照组的(57.45±8.14)%、(28.64±5.51)%、0.97±0.37,而观察组CD8^+水平为(23.52±6.45)%,明显低于对照组的(29.74±4.12)%,差异均有统计学意义(P<0.05)。治疗后观察组SP-A、SP-B、SP-C、SP-D以及5-HT水平明显低于对照组,差异均有统计学意义(P<0.05)。观察组1年内喘息复发1、2、≥3次患儿比例分别为14.00%、12.00%、6.00%,明显低于对照组,差异均有统计学意义(P<0.05)。结论增用孟鲁司特钠治疗呼吸道合胞病毒致毛细支气管炎患儿效果显著,有利于改善患儿免疫功能及SP、5-HT水平,预后较好,值得临床推广应用。

Objective To study the effects of adding montelukast sodium on the levels of CD3^+,CD4^+,CD8^+,pulmonary surfactant protein(SP)and serotonin(5-HT)in children patients with bronchiolitis caused by respiratory syncytial virus.Methods A total of 100 children patients with bronchiolosis caused by respiratory syncytial virus treated in the Xi′an municipal children′s hospital from March 2015 to August 2016 were selected and divided into the observation group and control group according to the random number table method,50 cases in each group.The control group received routine comprehensive treatment,and the observation group was added with montelukast sodium on the basis of conventional comprehensive treatment.The clinical indicators,CD3^+,CD4^+,CD8^+,SP and 5-HT levels were compared between the two groups.The recurrence situation of wheezing within 1 year and adverse reactions were also compared between the two groups.Results The cough disappearance time,wheezing disappearance time,oxygen therapy time and hospitalization time in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CD3^+,CD4^+and CD4^+/CD8^+after treatment in the observation group were(63.22±8.48)%,(34.72±7.07)%,and 1.72±0.45 respectively,which were significantly higher than(57.45±8.14)%,(28.64±5.51)%,0.97±0.37 in the control group,while the CD8^+level in the observation group was(23.52±6.45)%,which was significantly lower than(29.74±4.12)%in the control group,and the difference was statistically significant(P<0.05).The levels of SP-A,SP-B,SP-C,SP-D and 5-HT after treatment in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The proportions of the patients with wheezing recurrence once,twice and three times within 1 year in the observation group were 14.00%,12.00%and 6.00%,which were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Adding montelukast sodium in the treatment of child bronchiolitis caused by respiratory syncytial virus has obvious effect,which is beneficial to improve the immune function and SP,5-HT level,and has a better prognosis,and is worthy of clinical promotion and application.