孟鲁司特钠联合糠酸莫米松对轻中度腺样体肥大患儿TGF-β1、IL-17及Th17/Treg的影响  

Effect of montelukast sodium combined with mometasone furoate on TGF-β1,IL-17and Th17/Treg in patients with mild to moderate adenoid hypertrophy

作　　者：黎润球 何锦添[1] 叶贝华[1] LI Run-qiu;HE Jin-tian;YE Bei-hua(Department of E.N.T,the People′s Hospital of Dongguan,Guangdong Province,Dongguan 523059,China)

机构地区：[1]广东省东莞市人民医院耳鼻喉科,广东东莞523059

出　　处：《河北医科大学学报》2018年第4期434-439,共6页Journal of Hebei Medical University

摘　　要：目的观察孟鲁司特钠联合糠酸莫米松治疗轻中度腺样体肥大患儿的效果以及对血清TGF-β1、IL-17和Th17/Treg的影响。方法将98例轻中度腺样体肥大患儿根据病因(慢性炎症为1组,过敏性鼻炎为2组)和治疗方法分为4组:对照1组(22例)、对照2组(27例)、观察1组(24例)、观察2组(25例)。对照组应用糠酸莫米松治疗,观察组在对照组基础上加用孟鲁司特钠,治疗时间为2个月。采用OSA-18量表对4组进行症状评分,比较4组治疗前后腺样体与鼻咽腔比值(adenoids to nasopharynx,A/N)及临床疗效,并检测4组治疗前后血清转化生长因子β1(transforming growth factor-β1,TGF-β1)、白细胞介素17(interleukin 17,IL-17)及辅助性T细胞17(T helper17 cells,Th17)/调节性T细胞(regulatory T cells,Treg)的变化,观察4组的不良反应。结果治疗后,4组临床症状评分和A/N值均显著低于治疗前,且观察1组和观察2组均显著低于对照1组和对照2组,差异有统计学意义(P<0.05)。4组临床疗效和总有效率差异均有统计学意义(P<0.05)。治疗后,4组血清TGF-β1和IL-17均显著低于治疗前,且观察1组和观察2组均显著低于对照1组和对照2组,差异有统计学意义(P<0.05)。治疗后,4组Th17和Th17/Treg均显著低于治疗前,Treg显著高于治疗前,且观察1组和观察2组Th17和Th17/Treg均显著低于对照1组和对照2组,Treg显著高于对照1组和对照2组,差异有统计学意义(P<0.05)。结论孟鲁司特钠联合糠酸莫米松能有效治疗轻中度腺样体肥大,降低外周血血清TGF-β1和IL-17水平,减轻炎症反应,同时下调Th17/Treg比例,调节患儿免疫平衡;对炎症和过敏性鼻炎引起的轻中度腺样体肥大安全有效。Objective To analyze the clinical effect of montelukast sodium tablet combined with mometasone furoate in the treatment of mild to moderate adenoidal hypertrophy and influence on serum TGF-β1,IL-17 and Th17/Treg.Methods Ninety-eight cases of mild to moderate adenoidal hypertrophy child patients were divided into 4 groups according to the pathogeny and treating method:control group 1(22 cases),control group 2(27 cases),observation group 1(24 cases),observation group 2(25 cases).The control group was treated with mometasone furoate nasal spray,while observation group was treated with mometasone furoate combined with montelukast tablet.All patients were treated for 2 months.OSA-18 scale score was used to evaluate the clinical effect,the ratio of adenoids to nasopharynx(A/N)of 4 groups before and after treatment were compared.The clinical effect,serum transforming growth factor-β(TGF-β1),interleukin 17(IL-17)level and T helper 17 cells/regulatory T cells(Th17/Treg)of 4 groups were compared.The adverse effect was observed,too.Results After treatment,The OSA-18 score and A/N of all groups were decreased significantly(P<0.05),and that of observation group 1 and observation group 2 were significantly lower than control group 1 and control group 2,which showed significant difference(P<0.05).The clinical total effect of four groups showed significant difference(P<0.05).The serum TGF-β1,IL-17 level of all group were decreased significantly,and that of observation group 1 and observation group 2 were significantly lower than control group 1 and control group 2,which showed significant difference(P<0.05).After treatment,the Th17 and Th17/Treg ratio of all groups were decreased significantly,the Treg of all groups were increased significantly.The Th17 and Th17/Treg of observation group 1 and observation group 2 were significantly lowerr than control groups,the Treg of observation group 1 and observation group 2 were significantly higher than control groups(P<0.05),which showed significant difference.Conclusion Montelukast

关 键 词：增殖腺 孟鲁司特钠 糠酸莫米松 儿童 

分 类 号：R322.25[医药卫生—人体解剖和组织胚胎学]