【摘要】 目的探讨孟鲁司特钠联合普米克令舒治疗小儿支气管哮喘急性发作的疗效及对患儿炎症因子和免疫功能的影响。方法选择2019年3月至2020年3月广东省妇幼保健院儿科收治的支气管哮喘急性发作患儿114例,按照随机数表法分为观察组和对照组各57例。对照组患儿给予普米克令舒治疗,观察组在对照组治疗的基础上口服孟鲁司特钠片治疗。两组疗程均为14 d。比较两组患儿的治疗效果,以及治疗前后的肺功能、日间和夜间症状积分、炎症因子和免疫功能的变化。结果观察组患儿的治疗总有效率为92.98%,明显高于对照组的77.19%,差异有统计学意义(P<0.05);观察组和对照组患儿治疗后的FVC [(1.53±0.17) L vs (1.29±0.12) L]、FEV1%[(74.52±3.87)%vs (67.89±3.18)%]和FEV1/FVC [(72.10±2.53)%vs (65.78±3.08)%]比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);观察组和对照组患儿治疗后的日间症状积分[(1.19±0.25)分vs (1.64±0.29)分]、夜间症状积分[(1.23±0.28)分vs (1.60±0.17)分]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组和对照组患儿治疗后的血清IL-4 [(17.83±3.41) pg/mL vs (25.42±4.19) pg/mL]、IL-17 [(24.35±3.29) pg/mL vs (31.24±3.04) pg/mL]和IL-33 [(78.84±12.08) pg/mL vs (102.10±14.32) pg/mL]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组患儿治疗后的血清IgA为(1.09±0.13) g/L,明显高于对照组的(0.84±0.12) g/L,而IgG和IgM分别为(4.87±0.56) g/L、(1.03±0.12) g/L,明显低于对照组的(6.98±0.98) g/L、(1.25±0.16) g/L,差异均有统计学意义(P<0.05)。结论孟鲁司特钠联合普米克令舒治疗小儿支气管哮喘急性发作可减轻患儿炎症反应,提高患儿免疫功能,临床治疗效果良好。更多还原

【Abstract】 Objective To explore the therapeutic effect of montelukast sodium combined with Pulmicort Respules in the treatment of children’s bronchial asthma acute attack and its influence on inflammatory factors and immune function. Methods A total of 114 children with acute attack of bronchial asthma, who admitted to Department of Pediatrics, Guangdong Maternal and Child Health Hospital from March 2019 to March 2020, were selected and randomly divided into the observation group and control group, with 57 Children in each group. The control group was treated with Pulmicort Respules, while the observation group was treated with montelukast sodium on the basis of the control group.The course of treatment in both groups was 14 days. The treatment effect, pulmonary function, daytime and night symptom score, inflammatory factors, and immune function were compared between the two groups. Results The total effective rate of the observation group was 92.98% versus 77.19% of the control group(P<0.05). After treatment, FVC,FEV1%, FEV1/FVC of the observation group were(1.53±0.17) L,(74.52±3.87)%,(72.10±2.53)%, respectively, which were significantly higher than corresponding(1.29±0.12) L,(67.89±3.18)%,(65.78±3.08)% of the control group(all P<0.05); scores of daytime and night symptoms of the observation group were(1.19±0.25) points and(1.23±0.28) points,which were significantly lower than(1.64 ± 0.29) points and(1.60 ± 0.17) points of the control group(P<0.05); serum IL-4, IL-17, IL-33 of the observation group were(17.83±3.41) pg/mL,(24.35±3.29) pg/mL,(78.84±12.08) pg/mL, respectively, which were significantly lower than corresponding(25.42 ± 4.19) pg/mL,(31.24 ± 3.04) pg/mL,(102.10 ±14.32) pg/mL in the control group(all P<0.05); the serum IgA of the observation group after treatment was(1.09 ±0.13) g/L, which was significantly higher than(0.84 ± 0.12) g/L of the control group, while IgG and IgM were(4.87 ±0.56) g/L and(1.03±0.12) g/L, respectively, which were significantly lower than(6.98±0.98) g/L and(1.25±0.16) g/L of the control group(P<0.05). Conclusion In the treatment of acute attack of bronchial asthma in children, montelukast sodium combined with Pulmicort Respules can reduce the inflammatory reaction and improve the immune function of children, with good clinical treatment effect.更多还原