孟鲁司特钠联合甲泼尼龙对支原体肺炎患儿炎性因子和外周血淋巴细胞亚群的影响

Effects of Montelukast sodium combined with Methylprednisolone on inflammatory factors and peripheral blood lymphocyte subsets in children with mycoplasma pneumonia

目的观察孟鲁司特钠联合甲泼尼龙对支原体肺炎患儿炎性因子和外周血淋巴细胞亚群的影响。方法选取2018年1月至2019年6月本院收治的支原体肺炎患儿212例为研究对象,采用随机数表法将其分为观察组和对照组,每组各106例。给予对照组患儿常规治疗,观察组患儿在常规治疗基础上使用孟鲁司特钠联合甲泼尼龙治疗。观察并比较两组患儿的治疗总有效率、不良反应发生率、炎性因子和外周血淋巴细胞亚群水平。结果治疗后,两组患儿血清单核细胞趋化蛋白-1、降钙素原、细胞间黏附分子-1、白细胞介素-8、C反应蛋白、干扰素-γ、白细胞介素-17和外周血Th1细胞、Th17细胞水平均显著低于本组治疗前(均P<0.05),血清白细胞介素-4、转化生长因子-β和外周血调节性T细胞、Th2细胞水平均显著高于本组治疗前(均P<0.05),且观察组患儿上述指标变化幅度均显著大于对照组(均P<0.05)。观察组患儿治疗总有效率显著高于对照组(P<0.05),两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论孟鲁司特钠联合甲泼尼龙可有效抑制支原体肺炎的炎性反应,调节Th1、Th2、Th17、Treg细胞水平,临床疗效显著。

Objective To observe the effect of Montelukast sodium combined with Methylprednisolone on inflammatory factors and peripheral blood lymphocyte subsets in children with mycoplasma pneumonia.Method 212 children with mycoplasma pneumonia admitted to our hospital from January 2018 to June 2019 were randomly divided into control group and observation group,106 cases in each group.Control group children were given routine treatment,while observation group children were treated with Montelukast sodium combined with Methylprednisolone on the basis of routine treatment.The clinical efficacy and adverse reactions,and the levels of inflammatory factors and peripheral blood lymphocyte subsets of the two groups were observed and compared.Result After treatment,the levels of serum monocyte chemoattractant protein-1(MCP-1),procalcitonin(PCT),intercellular adhesion molecule-1(ICAM-1),interleukin-8(IL-8),C-reactive protein(CRP),interferon-γ(IFN-γ),interleukin-17(IL-17)and the levels of Th1 cells and Th17 cells in peripheral blood of the two groups were significantly lower than those before treatment(all P<0.05),while the levels of serum interleukin-4(IL-4),transforming growth factor-β(TGF-β),Treg cells and Th2 cells in peripheral blood were significantly lower than those before treatment(all P<0.05),and the changes of the above indexes in observation group were significantly larger than those in control group(all P<0.05).The total effective rate of observation group was higher than that of control group(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Montelukast sodium combined with Methylprednisolone can effectively inhibit inflammation and regulate the levels of Th1,Th2,Th17 and Treg cells of children with mycoplasma pneumonia,the clinical effect is remarkable.