孟鲁司特钠联合甲泼尼龙治疗儿童过敏性紫癜的效果及对患儿炎性因子和免疫功能的影响  

Efficacy of montelukast sodium combined with methylprednisolone in the treatment of allergic purpura in children and its effects on inflammatory factors and immune function

作　　者：赵云飞 王灵华 苏群燕 Zhao Yunfei;Wang Linghua;Su Qunyan(Department of Pediatrics,Taizhou Women and Children's Hospital,Taizhou 318000,Zhejiang Province,China;Department of Pediatrics,Taizhou Hospital Medical Center(Group)Enze Hospital,Taizhou 318050,Zhejiang Province,China)

机构地区：[1]台州市妇女儿童医院儿科,台州318000 [2]台州医院医疗中心(集团)恩泽医院儿科,台州318050

出　　处：《中国基层医药》2023年第6期814-818,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨孟鲁司特钠联合甲泼尼龙治疗儿童过敏性紫癜的效果及对患儿炎性因子和免疫功能的影响。方法选取台州市妇女儿童医院及台州医院医疗中心(集团)恩泽医院2019年3月至2021年3月收治的过敏性紫癜患儿94例为观察对象,采用随机数字表法分为观察组与对照组,每组47例。对照组给予甲泼尼龙治疗,观察组给予孟鲁司特钠联合甲泼尼龙治疗。两组疗程均为2周。比较两组治疗效果,治疗前后炎性因子和免疫功能的变化。结果观察组治疗2周总有效率[93.62%(44/47)]高于对照组[74.47%(35/47)](Z=2.15,P<0.05)。治疗后,两组血清白细胞介素4(IL-4)、IL-6和IL-18水平均低于治疗前(t观察组=21.19、22.26、27.20,t对照组=11.10、13.21、14.86,均P<0.05);观察组血清IL-4[(48.98±5.21)ng/L]、IL-6[(34.10±6.42)ng/L]和IL-18[(53.29±5.67)ng/L]水平均低于对照组[(65.38±7.08)ng/L、(47.83±4.71)ng/L、(67.83±7.10)ng/L](t=12.79、11.82、10.97,均P<0.05)。治疗后,两组CD_(3)^(+)、CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)均高于治疗前(t观察组=14.27、14.41、17.61,t对照组=6.90、5.12、7.40,均P<0.05);观察组CD_(3)^(+)[(68.94±2.89)%]、CD_(4)^(+)[(39.94±2.15)%]和CD_(4)^(+)/CD_(8)^(+)[(1.79±0.13)]均高于对照组[(63.86±3.28)%、(35.65±2.31)%和(1.53±0.16)](t=7.96、9.32、8.64,均P<0.05)。治疗后,两组血清IgG和IgM水平均低于治疗前(t观察组=21.00、7.99,t对照组=8.38、5.76,均P<0.05);观察组血清IgG[(1.43±0.19)g/L]和IgM[(9.74±0.78)g/L]水平均低于对照组[(1.95±0.37)g/L、(10.89±0.85)g/L](t=8.57、6.83,均P<0.05)。结论孟鲁司特钠联合甲泼尼龙治疗儿童过敏性紫癜疗效良好,且可减轻患儿炎性反应,提高免疫功能。Objective To investigate the efficacy of montelukast sodium combined with methylprednisolone in the treatment of pediatric allergic purpura and its effects on inflammatory factors and immune function.Methods A total of 94 children with allergic purpura who received treatment in Taizhou Women and Children's Hospital and Taizhou Hospital Medical Center(Group)Enze Hospital from March 2019 to March 2021 were included in this study.They were randomly divided into observation and control groups(n=47/group).The control group was treated with methylprednisolone.The observation group was treated with montelukast sodium combined with methylprednisolone.The course of treatment was 2 weeks in both groups.Efficacy and changes in inflammatory factors and immune function post-treatment relative to those pre-treatment were compared between the two groups.Results Total response rate in the observation group[93.62%(44/47)]was significantly higher than that in the control group[74.47%(35/47),Z=2.15,P<0.05)].After treatment,interleukin(IL-4),IL-6,and IL-18 levels in each group were significantly decreased compared with those before treatment(tobservation group=21.19,22.26,27.20,tcontrol group=11.10,13.21,14.86,all P<0.05).After treatment,IL-4,IL-6,and IL-8 levels in the observation group were(48.98±5.21)ng/L,(34.10±6.42)ng/L,and(53.29±5.67)ng/L,respectively,which were significantly lower than(65.38±7.08)ng/L,(47.83±4.71)ng/L,(67.83±7.10)ng/L in the control group(t=12.79,11.82,10.97,all P<0.05).After treatment,CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)in each group were significantly increased compared with those before treatment(tobservation group=14.27,14.41,17.61,tcontrol group=6.90,5.12,7.40,all P<0.05).After treatment,CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)in the observation group were(68.94±2.89)%,(39.94±2.15)%,and(1.79±0.13),respectively,which were significantly higher than(63.86±3.28)%,(35.65±2.31)%,and(1.53±0.16)in the control group(t=7.96,9.32,8.64,all P<0.05).After treatment,serum IgG and IgM level

关 键 词：紫癜 过敏性 儿童 白三烯拮抗剂 糖皮质激素类 炎症介导素类 炎症反应 自身免疫 治疗效果 

分 类 号：R725.5[医药卫生—儿科]