匹多莫德联合孟鲁司特治疗咳嗽变异性哮喘对免疫功能及血清细胞因子水平的影响

Influence of pidotimod in combination with montelukast on immune function and serum cytokine levels in children with cough variant asthma

目的分析应用匹多莫德联合孟鲁司特治疗咳嗽变异性哮喘患儿的免疫功能及血清细胞因子水平等指标变化情况。方法选取2020年1月至2022年12月泰州市第四人民医院收治的咳嗽变异性哮喘患儿,按照随机数字表法分为对照组和观察组。两组均采用常规对症处理,对照组在此基础上予以孟鲁司特钠咀嚼片治疗,观察组在对照组治疗基础上予以匹多莫德治疗。比较两组患儿日间、夜间咳嗽症状评分、肺功能、免疫功能及血清细胞因子水平及安全性。结果共纳入患儿90例,对照组与观察组各45例。治疗1个月后,两组患儿日间、夜间咳嗽症状评分及外周血CD8^(+)、血清淀粉样蛋白A(SAA)、IL-5、降钙素原(PCT)水平较治疗前降低,观察组较对照组更低[(0.36±0.11)分比(0.93±0.17)分、(0.41±0.12)分比(0.88±0.18)分、(21.26%±1.55%)比(26.44%±2.13%)、(42.21±4.03)mg/mL比(77.33±8.32)mg/mL、(5.67±1.03)ng/mL比(8.24±1.11)ng/mL、(0.42±0.08)ng/mL比(1.03±0.26)ng/mL],差异均有统计学意义(P<0.05);两组第1秒用力呼气量(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC水平及外周血CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前升高,观察组较对照组更高[(4.52±0.58)L比(3.31±0.21)L、(2.89±0.61)L比(1.76±0.55)L、(59.88%±2.65%)比(43.09%±3.23%)、(50.87%±5.46%)比(44.56%±4.78%)、(2.39±3.52)比(1.21±1.19)],差异均有统计学意义(P<0.05)。结论咳嗽变异性哮喘患儿应用匹多莫德联合孟鲁司特治疗后,患儿血清SAA、IL-5、PCT水平降低,炎症反应缓解,免疫功能及肺功能明显改善。

Objective To analyze the changes in immune function and serum cytokine levels in children with cough variant asthma after treatment with pidotimod in combination with montelukast.Methods From January 2020 to December 2022,Children with cough variant asthma were selected from the Taizhou Fourth People's Hospital and divided into control and observation groups using the random number table method.Both groups received conventional symptomatic treatment,the control group was treated with montelukast sodium chewable tablets on this basis,and the observation group was treated with pidotimod on the basis of the control group.The changes in daytime and nighttime cough symptom scores,lung function,immune function,and serum cytokine levels,as well as safety,were compared between the two groups.Results A total of 90 children were included,with 45 cases in the control group and 45 cases in the observation group.After one month of treatment,the daytime and nighttime cough symptom scores,peripheral blood levels of CD8^(+),serum amyloid A(SAA),IL-5,and procalcitonin(PCT)levels in both groups were lower than before treatment,and the observation group were lower than those in the control group[(0.36±0.11)points vs(0.93±0.17)points,(0.41±0.12)points vs(0.88±0.18)points,(21.26%±1.55%)vs(26.44%±2.13%),(42.21±4.03)mg/mL vs(77.33±8.32)mg/mL,(5.67±1.03)ng/mL vs(8.24±1.11)ng/mL,(0.42±0.08)ng/mL vs(1.03±0.26)ng/mL],with statistically significant differences(P<0.05);the first second forced expiratory volume(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC levels,and peripheral blood CD4^(+),CD4^(+)/CD8^(+)levels in both groups were higher than before treatment,and the observation group were higher than the control group[(4.52±0.58)L vs(3.31±0.21)L,(2.89±0.61)L vs(1.76±0.55)L,(59.88%±2.65%)vs(43.09%±3.23%),(50.87%±5.46%)vs(44.56%±4.78%),(2.39±3.52)vs(1.21±1.19)],with statistically significant differences(P<0.05).Conclusion In children with cough variant asthma treated with pidotimod in combination with montelukast,the levels of serum SAA,IL-5,and PCT are reduced,inflammation is alleviated,and immune function and lung function are significantly improved.