丙酸倍氯米松联合孟鲁司特钠治疗儿童变异性咳嗽及对eotaxin表达水平的影响-东南大学学报医学版

丙酸倍氯米松联合孟鲁司特钠治疗儿童变异性咳嗽及对eotaxin表达水平的影响

单位：安徽医科大学第一附属医院, 安徽合肥 230022

分类号：R453.9;R562

出版年·卷·期（页码）：2017·36·第二期（202-208）

摘要：

目的：探讨丙酸倍氯米松雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘疗效及对嗜酸粒细胞趋化因子表达水平和患儿肺功能的影响。方法：选取2014年1月至2016年1月接受治疗的82例咳嗽变异性哮喘患儿作为本次研究对象，按照数字表法将其随机分成对照组和研究组，每组41例。对照组患儿仅给予吸入丙酸倍氯米松混悬液进行治疗，研究组患儿在对照组治疗基础上加用孟鲁司特钠进行治疗，两组患儿均连续治疗3个月，比较两组患儿临床治疗总有效率和不良反应发生率，并分析两组患儿治疗前后血清白细胞介素（IL-5、IL-8和IL-10）水平、免疫球蛋白E（IgE）水平、肿瘤坏死因子（TNF）-α水平、肺功能[最大呼气中段流量（MMEF）、第1秒用力呼气容积（FEV1）以及用力肺活量（FVC）]、外周血嗜酸细胞及嗜酸粒细胞趋化因子表达水平情况。结果：对照组患儿临床治疗总有效率为70.73%，显著低于研究组患儿临床治疗总有效率（92.68%），两组差异具有统计学意义（P<0.05）。对照组患儿在治疗后其FEV1、FVC和MMEF值均明显低于研究组患儿，差异有统计学意义（P<0.05）。研究组患儿治疗后血清白细胞介素（IL-5、IL-8和IL-10）、IgE和TNF-α水平均明显低于对照组，差异具有统计学意义（P<0.05）。研究组患儿治疗后外周血嗜酸粒细胞和血清嗜酸粒细胞趋化因子水平均明显低于对照组，差异具有统计学意义（P<0.05）。对照组和研究组患儿治疗期间不良反应发生率分别为19.51%和9.76%，两组差异无统计学意义（P>0.05）。结论：丙酸倍氯米松混悬液雾化吸入联合孟鲁司特钠咀嚼片治疗咳嗽变异性哮喘疗效确切，可有效降低患儿气道炎症水平。此外，在肺功能改善和抑制Eotaxin表达方面具有显著作用。

Objective: To explore the effect of beclometasone dipropionate combined with montelukast sodium in children's cough variation asthma and its affection on levels of eotaxin expression and pulmonary function. Methods: 82 children with cough variant asthma treated in our hospital from January 2014 to January 2016 as research objects, and were randomly divided into control group and research group(41 cases in each group). The children in the control group was treated with beclomethasone dipropionate, and the children in the research group was treated with montelukast sodium based on the control group.The children in the two groups were treated continuously for 3 months.The total effective rate and adverse reaction rate were compared between the two groups. The levels of serum interleukin(interleukin-5,interleukin-8 and interleukin-10), levels of immunoglobulin E, tumor necrosis factor alpha,pulmonary function[maximal mid-expiratory flow (MMEF) curve, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)], peripheral eosinophils and eotaxin were compared between the two groups before and after treatment. Results: The total effective rate of the control group was 70.73%, which was significantly lower than that in the research group(92.68%),the difference had statistical meaning between the two groups(P<0.05).After treatment,the values of FEV1,FVC and MMEF in the control group were significantly lower than those in the research group, two sets of data had statistically significant differences(P<0. 05).After treatment, the levels of serum interleukin(interleukin-5,interleukin-8 and interleukin-10),immunoglobulin E and tumor necrosis factor alpha in the research group were significantly lower than those in the control group, the differences had statistical meanings between the two groups(P<0.05).After treatment, the peripheral eosinophils value and levels of eotaxin expression in the research group were significantly lower than those in the control group(P<0.05).The adverse reaction rate in the two groups were 19.51% and 9.76% respectively, the difference was not statistically significant(P>0.05).Conclusion: Beclometasone dipropionate combined with montelukast sodium has exact effect for children's cough variation, and it can decrease the level of airway inflammation, improve pulmonary function and inhibit eotaxin expression.

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