孟鲁司特钠联合布地奈德气雾剂治疗小儿支气管哮喘的疗效及对免疫炎症指标的影响

Effects of montelukast sodium tablets combined with pulmicort aerosol in the treatment of children with asthma and its influence on EOS,IL-4,IgE,TNF-α

目的:探讨孟鲁司特钠联合布地奈德气雾剂治疗小儿支气管哮喘的疗效及对嗜酸性粒细胞(EOS)、白细胞介素4(IL-4)、免疫球蛋白E(IgE)、肿瘤坏死因子α(TNF-α)影响。方法:选择2018年3月至2019年3月杭州市大江东医院收治的支气管哮喘患儿142例,依据随机数字表法分为观察组71例与对照组71例。观察组患儿采用孟鲁司特钠片联合布地奈德气雾剂治疗,对照组患儿采用布地奈德气雾剂治疗。两组疗程均为2周。比较两组治疗疗效;两组治疗前后EOS、IL-4、IgE和TNF-α水平变化,日间和夜间哮喘症状评分变化。结果:观察组治疗总有效率(91.55%)高于对照组(74.65%),差异有统计学意义(χ ^2=7.220, P<0.05)。观察组治疗后日间哮喘症状评分(0.38±0.12)分和夜间哮喘症状评分(0.42±0.14)分,低于对照组的(0.87±0.19)分和(0.93±0.25)分( t=18.373、14.998,均 P<0.05)。观察组治疗后EOS(0.38±0.09)×10^ 9/L、IL-4(13.89±3.25)ng/L、IgE(109.35±16.57)kU/L和TNF-α(1.25±0.12)ng/L,低于对照组的(0.73±0.13)×10^ 9/L、(18.36±2.70)ng/L、(164.53±23.51)kU/L和(1.49±0.15)ng/L,差异均有统计学意义( t=18.652、8.914、16.165、10.528,均 P<0.05)。 结论:孟鲁司特钠联合布地奈德气雾剂对小儿支气管哮喘疗效明显,可降低EOS、IL-4、IgE和TNF-α水平,减轻日间和夜间哮喘症状。

Objective To investigate the effect of montelukast sodium tablets combined with pulmicort aerosol in the treatment of children with asthma,and its influence on eosinophil(EOS),interleukin-4(IL-4),immunoglobulin E(IgE),tumor necrosis factor-α(TNF-α).Methods From March 2018 to March 2019,142 children with asthma admitted to Hangzhou Dajiangdong Hospita were randomly divided into observation group(71 cases)and control group(71 cases)according to the digital table.The patients in the observation group were treated with montelukast sodium tablets combined with pulmicort aerosol,while patients in the control group were treated with pulmicort aerosol.Both two groups were treated for 2 weeks.The levels of EOS,IL-4,IgE and TNF-α,day and night asthma symptom scores and blood gas analysis indicators before and after treatment were compared between the two groups.Results The total effective rate of the observation group(91.55%)was higher than that of the control group(74.65%)(χ^2=7.220,P<0.05).After treatment,the scores of asthma symptoms in day[(0.38±0.12)points]and night[(0.42±0.14)points]in the observation group were lower than those in the control group[(0.87±0.19)points and(0.93±0.25)ponts](t=18.373,14.998,all P<0.05).After treatment,the levels of EOS[(0.38±0.09)×10^9/L],IL-4[(13.89±3.25)ng/L],IgE[(109.35±16.57)kU/L]and TNF-α[(1.25±0.12)ng/L]in the observation group were lower than those in the control group[(0.73±0.13)×109/L,(18.36±2.70)ng/L,(164.53±23.51)kU/L and(1.49±0.15)ng/L](t=18.652,8.914,16.165,10.528,all P<0.05).Conclusion Montelukast sodium tablets combined with pulmicort aerosol is effective in the treatment of children with asthma.It can reduce the levels of EOS,IL-4,IgE and TNF-α,alleviate the symptoms of daytime and night asthma.