孟鲁司特对哮喘患儿血浆炎症因子的影响和疗效分析  

The influence and curative effect of montelukast on plasma level of cytokines of asthma children

作　　者：胡小红[1] 凌杰[2] 

机构地区：[1]浙江省杭州市萧山区第一人民医院儿科,浙江杭州311200 [2]浙江省台州市第一人民医院检验科,浙江台州318020

出　　处：《中国现代医生》2013年第6期54-55,58,共3页China Modern Doctor

基　　金：浙江省台州市科技计划项目(061KY66)

摘　　要：目的探讨孟鲁司特对哮喘患儿血浆炎症因子的影响和疗效分析。方法选择急性发作期的哮喘儿童68例随机分为治疗组和对照组各34例。两组患儿均常规预防感染、止咳祛痰、平喘及激素雾化吸入等治疗。治疗组在其基础上加用孟鲁司特钠咀嚼片5 mg/次,1次/d,连用8周。比较两组患儿治疗前后血浆炎症因子肿瘤坏死因子-α(TNF-α)、白介素-5(IL-5)、白介素-8(IL-8)和白介素-10(IL-10)水平的变化,观察临床疗效及不良反应,并随访观察治疗半年、1年内哮喘的复发率。结果治疗8周后两组患儿血浆TNF-α、IL-5和IL-8的水平明显下降,IL-10水平明显上升(P<0.05或P<0.01),且治疗组下降或上升值较对照组更明显(P<0.05);同时疗效分析发现,治疗组的临床总有效率明显高于对照组(χ2=6.48,P<0.05)。两组患儿治疗期间均无明显的药物过敏不适症状。对治疗有效患儿随访观察半年和1年,观察组哮喘的复发率均明显低于对照组(χ2=6.44、6.13,P<0.05)。结论孟鲁司特治疗儿童哮喘安全有效,能降低哮喘的复发率,是治疗和预防儿童哮喘急性发作的一种理想药物,作用与其能调节血浆炎症因子的水平密切相关。Objective To explore the influence and curative effect of montelukast on plasma level of inflammatory cy- tokines of asthma child. Methods Sixty-eight asthma children during acute attack were divided into two groups as treatment group and control group. All the children got fundamental treatment as anti-infection, cough-relieving, spu- tum-reducing, asthma-relieving and hormone-aerosol-inhalation. And the children of treatment group got extra treat- ment as taking montelukast sodium chewable tablets 5mg per time, once a day, for 8 weeks. The plasma levels of TNF-α, IL-5, IL-8, IL-10 and the clinic curative effect and adverse reaction were observed, and so were the recur- rence rate within half a year and within a year. Results The plasma levels of TNF-α, IL-5 and IL-8 descended sig- nificantly comparing with 8 weeks before treatment, but the level of IL-10 was the opposite （P 〈 0.05 or P 〈 0.01）, and the rangeability of treatment group was more significantly obviously than that of control group （P 〈 0.05）. The total clinic effective rate of treatment group was significantly higher than that of control group （x^2 =6.48 ,P 〈 0.05）. No obvi- ously reverse reaction was found during the therapy period of both the two groups. Half a year and one year after treat- ment, the recurrence rate of treatment group were significantly lower than that of control group （X2 =6.44 and 6.13 ,P 〈 0.05）. Conclusion Treating asthma children with montelukast shows safe, effective and low-recurrence rate. Mon- telukast is an ideal drug to treat and prevent children asthmatic attack. Maybe its mechanism was related with regulat- ing the levels of plasma cytokines.

关 键 词：哮喘 孟鲁司特 炎症因子 复发 

分 类 号：R725.6[医药卫生—儿科]