强化免疫疗法辅助治疗对咳嗽变异性哮喘患儿免疫系统及嗜酸性粒细胞的影响

Effect of Intensive Immunotherapy on Immune System and Eosinophils in Children with Cough Variant Asthma

目的 :探讨强化免疫疗法辅助孟鲁司特钠咀嚼片对咳嗽变异性哮喘(CVA)患儿免疫功能及嗜酸性粒细胞(EOS)水平的影响。方法 :选择2015年3月—2017年1月我院收治的CVA患儿160例为研究对象,按照随机数字表法分为观察组和对照组,各80例。对照组在常规疗法的基础上给予孟鲁司特钠咀嚼片(5 mg,qd)治疗,观察组在对照组基础上联合强化免疫疗法治疗,比较两组疗效、炎症因子水平、免疫功能以及EOS水平状态;比较两组治疗前后肺功能变化。结果 :观察组治疗总有效率高于对照组,差异有统计学意义(P <0.05);治疗后两组CD8+、免疫球蛋白(Ig)E、EOS计数水平均显著低于治疗前,且观察组低于对照组,CD4+水平及CD4+/CD8+均显著高于治疗前,且观察组高于对照组,差异均有统计学意义(P <0.05);治疗后两组超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-4及肿瘤坏死因子(TNF)-α水平显著低于治疗前,且观察组低于对照组,差异有统计学意义(P <0.01);治疗后两组呼气高峰流量(PEFR)、1秒用力呼气容积(FEV1)、用力肺活量(FVC)水平均较治疗前显著升高,且观察组显著高于对照组,差异有统计学意义(P <0.05)。结论 :强化免疫疗法联合孟鲁司特钠咀嚼片治疗小儿CVA的疗效确切,可明显缓解临床症状,抑制炎症反应,提高免疫功能,降低EOS水平,值得临床推广应用。

Objective: To investigate the effect of intensive immunotherapy combined with montelukast sodium chewable tablets on immune functions and eosinophil(EOS) level in children with cough variant asthma(CVA). Methods: 160 children with CVA admitted to our hospital from March 2015 to January 2017 were selected as subjects investigated and randomly divided into an observation group and a control group, 80 cases in each group. The children in the control group were treated with montelukast sodium chewable tablets(5 mg, qd) on the basis of conventional therapy, and the children in the observation group were given intensive immunotherapy on the basis of the control group. The efficacy, inflammatory factor levels, immune functions and EOS level were compared between the two groups, and the changes in lung functions before and after treatment were compared between the two groups. Results: The total effective rate in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). The levels of CD8+, immunoglobulin(Ig)E and EOS count in the two groups after treatment were significantly lower than those before treatment, and the levels of CD8+, IgE and EOS count in the observation group were lower than those in the control group, while the levels of CD4+ and CD4+/CD8+ were significantly higher than those in the control group, with statistically significant differences(P<0.05). The levels of high-sensitivity C-reactive protein(hs-CRP), interleukin(IL)-4 and tumor necrosis factor(TNF)-α in the two groups after treatment were significantly lower than those before treatment, and the levels in the observation group were lower than those in the control group, with statistically significant differences(P<0.01). The levels of peak expiratory flow rate(PEFR), forced expiratory volume in 1 second(FEV1) and forced vital capacity(FVC) in the two groups after treatment were significantly higher than those before treatment, and the levels in the observation group were significantly higher than those in the control group, with statistically significant differences(P<0.05). Conclusion: Intensive immunotherapy combined with montelukast sodium chewable tablets is effective in the treatment of children with CVA, and can significantly relieve clinical symptoms, inhibit inflammation, improve immune function and reduce EOS levels, and which is worthy of clinical application.