孟鲁司特钠治疗儿童咳嗽变异型哮喘的疗效及其对患者血清免疫球蛋白E、白介素-4的影响

Clinical effects of montelukast in the treatment of cough variant asthma(CVA) and its influence on serum IgE and IL-4

目的探讨孟鲁司特钠对儿童咳嗽变异型哮喘(CVA)的临床疗效及其对患儿血清免疫球蛋白E(IgE)以及白介素-4(IL-4)的影响。方法将2013年1月至2015年2月我院儿科收治的98例CVA患儿以数表法随机分为观察组(n=49)与对照组(n=49),对照组给予布地奈德气雾剂治疗,观察组在对照组基础上加用孟鲁司特钠治疗,比较两组患儿的临床疗效,以及治疗前后患儿血清IgE及IL-4水平的变化情况。结果观察组患儿的治疗总有效率为95.9%(47/49),显著高于对照组的67.3%(33/49),差异有显著统计学意义(P<0.01);观察组患儿的咳嗽缓解时间和咳嗽消失时间分别为(3.82±1.11)d和(6.46±1.38)d,均显著短于对照组的(6.02±1.14)d和(10.23±1.50)d,差异均有显著统计学意义(P<0.01);治疗后观察组IgE为(148.2±43.5)KU/L,IL-4为(67.6±11.7)ng/m L,均显著低于治疗前的(277.4±44.2)KU/L与(90.4±12.2)ng/m L,对照组治疗后IgE为(168.3±42.9)KU/L,IL-4为(75.4±12.1)ng/m L,均显著低于治疗前的(278.3±43.6)KU/L与(91.0±12.4)ng/m L,且治疗后观察组的IgE及IL-4水平均明显低于对照组,差异均有统计学意义(P<0.05)。结论孟鲁司特钠用于CVA患儿的治疗能够有效降低IgE、IL-4水平,抑制Ⅰ型变态反应,从而更加快速的缓解患儿临床症状,疗效确切,安全可靠,值得推广应用。

Objective To discuss the clinical effect of montelukast in the treatment of effect cough variant asthma(CVA) and its influence on serum immunoglobulin E(IgE) and interleukin-4(IL-4). Methods A total of 98 children with CVA, who admitted to the Department of Pediatrics in our hospital from January 2013 to February 2015, were randomly divided into the observation group(n=49) and the control group(n=49) according to digital table. The control group was treated with budesonide aerosol, and the observation group were treated with budesonide aerosol and montelukast. Then the clinical effects and level changes of IgE and IL-4 were contrasted between the two groups. Results The effective rate of the observation group [95.9%(47/49)] was significantly higher than that of the control group [67.3%(33/49)](P<0.01). The time of cough relief and disappearance time in the observation group [(3.82±1.11) d,(6.46±1.38) d, respectively] were significantly shorter than those in the control group [(6.02±1.14) d,(10.23±1.50) d, respectively](P<0.01). In the observation,the levels of IgE and IL-4 after the treatment [(148.2±43.5) KU/L,(67.6±11.7) ng/m L, respectively] were significantly lower than before the treatment [(277.4±44.2) KU/L,(90.4±12.2) ng/m L, respectively](P<0.01); In the control group, the levels of IgE and IL-4 after the treatment [(168.3±42.9) KU/L,(75.4±12.1) ng/m L, respectively] were significantly lower than before the treatment [(278.3±43.6) KU/L,(91.0±12.4) ng/m L, respectively](P<0.01), and the levels of IgE and IL-4 of the observation group were significantly lower than those of the control group(P<0.01). Conclusion Montelukast can effectively reduce the level of IgE and IL-4, inhibit type Ⅰ allergic reaction, and more rapidly relieve the clinical symptoms.Montelukast is effective, safe and reliable in the treatment of cough variant asthma, which is worth popularizing.