舒利迭联合白三烯抑制剂口服治疗对支气管哮喘患儿外周血TLR 4、STAT 1的影响

Effect of Seretide Combined with Leukotriene Inhibitors in the Treatment of Asthma Child Patients and Influence on TLR 4, STAT 1 Expression

目的探究舒利迭联合白三烯抑制剂对支气管哮喘患儿的疗效以及对其外周血Toll样受体4(toll-like receptor 4, TLR 4)mRNA、信号转导激活因子1(signal transducers and activators of transcription1, STAT 1)的影响。方法 2015-02/2017-02月在作者医院接受治疗的140例哮喘患儿被随机分为单药治疗组和联合治疗组,每组70例。单药治疗组进行舒利迭吸入治疗,联合治疗组采用孟鲁司特联合舒利迭治疗。治疗12周后比较两组患儿的肺功能、临床疗效,并比较两组治疗前后外周血TLR 4 mRNA、STAT 1 mRNA的表达、嗜酸性粒细胞(eosinophils, EOS)百分比以及血清炎症因子水平。观察两组不良反应。结果治疗前,两组各项指标差异均无统计学意义(P>0.05)。治疗后,联合治疗组第1秒用力呼气量(forced expiratory volumn in 1s, FEV1)、肺活量(forced vital capacity, FVC)、FEV1/FVC显著高于单药治疗组,残气量(residual volume, RV)、RV/肺总量(total lung volume,TLC)、呼气高峰流量变异率(peak expiratory flow rate, PEFR)显著低于单药治疗组,组间比较差异具有统计学意义(P<0.05);联合治疗组总有效率为91.43%,显著高于单药治疗组78.57%(P<0.05)。联合治疗组外周血TLR 4 mRNA,STAT 1 mRNA表达,嗜酸性粒细胞百分比,血清白细胞介素6(interleukin-6, IL-6)、IL-8和肿瘤坏死因子α(tumor necrosis factor alpha, TNF-α)水平较单药治疗组下降更明显(P<0.05)。两组均未发生严重不良反应。结论舒利迭联合孟鲁司特能有效提高哮喘患儿临床疗效,改善肺功能,降低外周血TLR 4 mRNA和STAT 1 mRNA表达,降低EOS百分比,减轻炎症反应。

Objective To analyze the clinical effect of seretide combined with leukotriene inhibitors in the treatment of asthma child patients and the influence on peripheral blood toll-like receptor 4(TLR 4),signal transducers and activators of transcription1(STAT 1)expression.Methods A total of 140 asthma child patients received treatment in authors’hospital from February 2015 to Feburary 2017 were randomly divided into monotherapy group and combination group,each group with 70 cases.The monotherapy group was treated with seretide inhalation,while the combination group was treated with seretide inhalation combined with montelukast.The lung function,clinical effect,the peripheral blood TLR 4,STAT 1 mRNA expression,percentage of eosinophil(EOS)and serum inflammatory factors of two groups before and after treatment were compared.The adverse reactions were observed.Results All indexes of two groups were not significant differences before treatment(P>0.05).The forced expiratory volumn in 1 s(FEV1),forced vital capacity(FVC),FEV1/FVC indexes of the combination group were significantly higher than those in monotherapy group after treatment(P<0.05),and the residual volume(RV),RV/total lung volume(TLC),peak expiratory flow rate(PEFR)indexes of the combination group were significantly lower than those in monotherapy group after treatment(P<0.05).The clinical total effective rate of combination group was significantly higher than that of monotherapy group(91.43%vs.78.57%,P<0.05).The peripheral blood TLR 4,STAT 1 mRNA expression,percentage of EOS and the expression levels of interleukin-6(IL-6),IL-8,tumor necrosis factor alpha(TNF-α)of combination group were significantly decreased than those in monotherapy group(P<0.05).Without serious adverse reactions occurred in two groups.Conclusion Seretide combined with montelukast can effectively improve the clinical effect in treating asthma child patients.Which can improve the lung function,decrease the expression of peripheral blood TLR 4 and STAT 1,decrease the percentage of EOS,alleviate inflammatory reaction.