小儿哮喘患儿经普米克令舒联合孟鲁司特治疗前后肺功能及免疫学细胞因子水平变化研究

Changes of lung function and immunocytokine levels in children with asthma before and after treatment with Pulmicort-Respules combined with montelukast

目的分析小儿哮喘患儿经普米克令舒联合孟鲁司特治疗前后肺功能及免疫学细胞因子水平变化。方法选取2018年3月至2019年3月本院儿科收治的哮喘患儿86例,中途退出4例,最终纳入82例。按照治疗方法将其分为联合组和单一组,各组41例。单一组在常规治疗基础上增加孟鲁司特钠咀嚼片,联合组在单一组基础上增加普米克令舒。比较治疗前后对2组肺功能,包括用力肺活量(FVC)、第一秒用力呼气量(FEV1)及第一秒用力呼气量/用力肺活量(FEV1/FVC);临床疗效、治疗前后哮喘发作持续时间及次数;IgE、TSLP水平及外周血TLRs表达情况。结果联合组治疗后FVC、FEV1、FEV1/FVC水平均高于单一组,差异具有统计学意义(P<0.05);IgE及TSLP水平下降程度较单一组更为显著,差异具有统计学意义(P<0.05);TLR2及TLR4表达强度变化均较单一组更为显著,差异具有统计学意义(P<0.05)。2组治疗前两组哮喘发作次数和发作持续时间间比较,差异无统计学意义(P>0.05),而治疗后联合组哮喘发作次数和发作持续时间均小于单一组(P<0.05),且联合组临床总有效率较单一组高(P<0.05)。结论普米克令舒联合孟鲁司特治疗可改善哮喘患儿肺功能和免疫功能,并参与调节TLRs信号通路,临床疗效显著,值得推广。

Objective To analyze the changes of lung function and cytokine levels in children with asthma before and after treatment with Pulmicort-Respules combined with montelukast.Methods 86 children with asthma treated in our pediatric department from March 2018 to March 2019 were selected,4 patients withdrew midway and 82 patients were finally included.According to the treatment method,they were divided into a combination group and a single group,with 41 cases in each group.The single group were supplemented with montelukast sodium chewable tablets based on conventional treatment,and the combination group were supplemented with Pulmicort-Respules based on treatment of single group.Pulmonary function was compared between the two groups before and after treatment,including forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC).Clinical efficacy,duration and times of asthma attacks before and after treatment were compared.IgE,TSLP levels and TLRs expression in peripheral blood were analyzed.Results After treatment,the levels of FVC,FEV1,FEV1/FVC in the combination group were higher than those in the single group.The decreasing of IgE and TSLP levels was more significant than that of the single group,and the difference was statistically significant(P<0.05).The changes of TLR2 and TLR4 expression in the combination group were more significant than those in the single group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the times of asthma attacks and duration between the two groups before treatment(P>0.05),while the times of asthma attacks and duration of attacks in the combination group were lower than those in the single group after treatment(P<0.05),and the total clinical effective rate of the combination group was higher than that of the single group(P<0.05).Conclusion Pulmicort-Respules combined with montelukast can improve the lung function and immune function of children with asthma and participate in the regulation of TLRs signaling pathway.The clinical effect is significant and it is worthy of promotion.