强化减肥联合孟鲁司特钠在改善肥胖支气管哮喘儿童肺部炎症中的应用

The application of intensive weight loss combined with montelukast sodium in improving the lung inflammation in obese children with bronchial asthma

目的探讨强化减肥联合孟鲁司特钠在改善肥胖支气管哮喘(BA)儿童肺部炎症中的应用。方法选取2015年12月至2018年6月收治的肥胖BA患儿80例,依据随机数字表法分为孟钠组和强孟组,每组40例。孟钠组给予孟鲁司特钠治疗,强孟组在此基础上给予强化减肥,比较2组体重指数(BMI)、肺部炎症[白介素(IL)-4、IL-5、IL-10]、肺功能[第1秒用力呼气量(FEV1)、用力肺活量(FVC)、峰流速(PEFR)]、治疗疗效、不良反应。结果强孟组治疗后BMI明显低于治疗前,强孟组治疗后BMI明显低于孟钠组,差异有统计学意义(P<0.05);孟钠组和强孟组治疗后IL-4、IL-5明显低于治疗前,孟钠组和强孟组治疗后IL-10、FVC、FEV1、PEFR明显高于治疗前,强孟组治疗后IL-4、IL-5明显低于孟钠组,强孟组治疗后IL-10、FVC、FEV1、PEFR明显高于孟钠组,差异有统计学意义(P<0.05);强孟组治疗有效率明显高于孟钠组,差异有统计学意义(P<0.05);孟钠组和强孟组不良反应率比较,差异无统计学意义(P>0.05)。结论强化减肥联合孟鲁司特钠可有效改善肥胖BA患儿肥胖、肺部炎症状态,有利于改善患儿肺功能,且安全性好,值得临床推广。

Objective To investigate the application value of intensive weight loss combined with montelukast sodium in improving the lung inflammation in obese children with bronchial asthma(BA).Methods Eighty obese children with BA who were treated from December 2015 to June 2018 were enrolled in the study,who were divided into montelukast sodium group(n=40)and intensive montelukast sodium group(n=40)according to the random number table.The patients in montelukast sodium group were treated by montelukast sodium only,however,on this basis,the patients in intensive montelukast sodium group were treated by intensive weight loss.The body mass index(BMI),pulmonary inflammation indexes[interleukin(IL)-4,IL-5,IL-10],pulmonary function forced expiratory volume 1st(FEV1),forced vital capacity(FVC),peak flow rate(PEFR),therapeutic efficacy and adverse reactions were observed and compared between the two groups.Results After treatment,the BMI levels in intensive montelukast sodium group were significantly lower than those before treatment,moreover,which in intensive montelukast sodium group were significantly lower than those in montelukast sodium group(P<0.05).And the levels of IL-4,IL-5 in both groups were significantly decreased,as compared with those before treatment,however,the levels of IL-10,FVC,FEV1,PEFR in both groups were significantly increased,as compared with those before treatment,moreover,the levels of IL-4,IL-5 in intensive montelukast sodium group were significantly lower than those in montelukast sodium group,and the levels of IL-10,FVC,FEV1,PEFR in intensive montelukast sodium group were significantly higher than those in montelukast sodium group(P<0.05).In addition the effective rate in intensive montelukast sodium group was significantly higher than that in montelukast sodium group(P<0.05),but there was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Intensive weight loss combined with montelukast sodium can effectively improve the obesity and pulmonary inflammation status in obese children with BA,which is conducive to improving the pulmonary function,with good safety,therefor,it is worthy of further clinical promotion.