孟鲁司特上调Treg数量在儿童急性支气管哮喘治疗中发挥作用

Montelukast affects the treatment of children with acute bronchial asthma by up-regulating Treg numbers

为探究孟鲁司特在儿童支气管哮喘治疗中的作用及机制,自海南医学院第二附属医院收集108例急性支气管哮喘病例,随机分为孟鲁司特治疗组63例和常规治疗组45例。检测治疗前后患儿肺功能,进行疗效评分;FACS检测治疗前后患儿外周血Treg数量及百分比变化;ELISA检测治疗前后患儿血清炎性因子变化。结果显示,孟鲁司特治疗组及常规治疗组治疗前后患儿肺功能得到显著改善(P<0.05,P<0.01);孟鲁司特治疗组的疗效评分显著高于常规治疗组(P<0.05);孟鲁司特治疗组及常规治疗组治疗前后Treg数量及百分比显著增加(P<0.05,P<0.01);孟鲁司特治疗组及常规治疗组治疗前后炎性因子IL-4、IL-5、IL-6水平显著降低,IL-10、IFN-γ和IgE水平显著升高(有P<0.05,P<0.01)。上述指标中孟鲁司特治疗组均明显优于常规治疗组。由此,孟鲁司特可能通过影响炎性因子的表达调节Th1/Th2平衡,使Treg数量增加,患儿肺功能改善,从而有效治疗儿童急性支气管哮喘。

In order to study the role and mechanism of montelukast in the treatment of bronchial asthma in children, 108 patients with acute bronchial asthma were enrolled from the Second Affiliated Hospital of Hainan Medical College and randomly divided into montelukast treatment group(63 cases) and conventional treatment group(45 cases). Patients’ lung function before and after treatment was detected and the efficacy score after treatment was evaluated;FACS was used to detect the changes in Treg number and percentage;ELISA was used to detect the changes of inflammatory factors before and after treatment. The results showed that montelukast could significantly improve patients’ lung function compared with before treatment, so as the conventional treatment group(P<0.05, P<0.01);The efficacy score of montelukast treatment group was significantly higher than that of conventional treatment group(P<0.05);Compared with the before treatment group, the montelukast treatment group significantly reduced the levels of inflammatory factors IL-4, IL-5, IL-6 and increased IL-10, IFN-γ and IgE levels, so as the conventional treatment group(P<0.05, P<0.01). In addition, montelukast can significantly increase the number and percentage of Treg(P<0.05, P<0.01). And the above indexes showed the advantages of montelukast treatment. As a result, montelukast regulates the Th1/Th2 balance by regulating inflammatory factors expressions, who increases the expression of Treg, and improves patient’s lung function, thereby effectively improve the treatment of children with acute bronchial asthma.