孟鲁司特钠对阻塞性睡眠呼吸暂停低通气综合征儿童miRNA-34a和miRNA-23a表达的影响  

Effect of Montelukast Sodium on Mirna-34a and Mirna-23a in Children with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：宣妙燕 郁峰[1] 黄秋玲[1] XUAN Miao-Yan;YU Feng;HUANG Qiu-Ling(Department of Pediatrics,The Central Hospital of Huzhou city,Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市中心医院儿科,浙江湖州313000

出　　处：《中国妇幼保健》2022年第1期58-61,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2018KY783)。

摘　　要：目的探讨孟鲁司特钠对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)miRNA-34a和miRNA-23a表达的影响,为临床用药提供有效指导。方法选取该院2018年9月—2019年9月收治的91例OSAHS患儿为研究对象,依据盲抽法分为对照组45例与观察组46例。两组均予以临床常规治疗,对照组给予匹多莫德口服治疗,观察组给予孟鲁司特钠口服治疗,连续治疗3个月后,比较两组临床疗效、炎症因子水平、免疫功能、miRNA-34a与miRNA-23a表达及不良反应总发生率。结果观察组临床总有效率为93.8%,高于对照组的71.11%,差异有统计学意义(P<0.05)。两组治疗3个月后白介素-6(IL-6)[(80.15±20.16)pg/ml、(97.84±20.46)pg/ml]、超敏C-反应蛋白(hs-CRP)[(1.12±0.42)mg/L、(3.24±0.53)mg/L]及肿瘤坏死因子-α(TNF-α)[(89.57±22.45)pg/ml、(103.24±20.64)pg/ml]水平均较治疗前降低[(150.53±26.54)pg/ml、(150.24±26.72)pg/ml;(7.48±0.59)mg/L、(7.53±0.58)mg/L;(142.16±30.26)pg/ml、(143.24±30.52)pg/ml],且相较对照组,观察组各指标水平更低,差异有统计学意义(P<0.05);两组治疗3个月后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均较治疗前升高,CD8^(+)水平较治疗前降低,且相较对照组,观察组各指标水平变化显著,差异有统计学意义(P<0.05);两组治疗3个月后miRNA-34a与miRNA-23a表达均较治疗前降低,且相较对照组,观察组各指标表达更低,差异有统计学意义(P<0.05);观察组不良反应总发生率较对照组相比,差异无统计学意义(P>0.05)。结论OSAHS患儿应用孟鲁司特钠治疗疗效较佳,可抑制机体炎症反应,提高免疫功能,减少miRNA-34a、miRNA-23a表达,且安全性高,不良反应少。Objective To explore the clinical effect of montelukast sodium on miRNA-34 a and miRNA-23 a in children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 91 patients with OSAHS who were admitted to the Hospital from September 2018 to September 2019 were enrolled.They were divided into a control group(45 cases)and an observation group(46 cases)according to the blind drawing method.Conventional treatment was carried out in both groups.The control group was given oral treatment with Pidomod and the observation group was given oral treatment with Montelukast Sodium.After 3 month of continuous treatment,the clinical efficacy,insulin factors,immune function,expression of miRNA-34 a and miRNA-23 a,and the overall incidence of adverse reactions were compared between the two groups.Results The total clinical effective rate of the obser vation group was 93.8%higher than that of the control group 71.11%,the difference was statistically significant(P<0.05).The levels of interleukin-6(IL-6)[(80.15±20.16)pg/ml,(97.84±20.46)pg/ml],high-sensitivity C-reactive protein(hs-CRP)[(1.12±0.42)mg/L,(3.24±0.53)mg/L],and tumor necrosis factor-α(TNF-α)[(89.57±22.45)pg/ml,(103.24±20.64)pg/ml]in were reduced in both groups than before treatment[(150.53±26.54)pg/ml,(150.24±26.72)pg/ml;(7.48±0.59)mg/L,(7.53±0.58)mg/L;(142.16±30.26)pg/ml,(143.24±30.52)pg/ml],and the levels in the observation group were shown to be lower than those in the control group,where the difference was statistically significant(P<0.05).After 3 month of treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were increased,and the CD8^(+)level was reduced than before treatment in both groups,and the changes in the observation group were shown to be more significant than those in the control group,and the difference was statistically significant(P<0.05).After 3 month of treatment,the expression of miRNA-34 a and miRNA-23 a were reduced in both groups,and the expression in the observation group was lower,where the difference was statistically signif

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 孟鲁司特钠 匹多莫德 炎症因子 免疫功能 不良反应 

分 类 号：R72[医药卫生—儿科]