孟鲁司特对间歇性哮喘急性发作期患儿嗜酸粒细胞计数、白介素6的影响及其与气道功能指标的相关性研究  

Effect of Montelukast on Eosinophil Count and Interleukin 6 in Children with Acute Attack of Intermittent Asthma and Their Correlation with Airway Function Indexes

作　　者：曹静 陈刚 耿玉荣 刘倩 刘晓丽 宋俊花 CAO Jing;CHEN Gang;GENG Yurong;LIU Qian;LIU Xiaoli;SONG Junhua(Department of Pediatrics,Huanghua Municipal People's Hospital,Huanghua 061100,China)

机构地区：[1]河北省黄骅市人民医院儿科,061100

出　　处：《实用心脑肺血管病杂志》2024年第6期107-111,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省沧州市科技计划项目(213106144)。

摘　　要：目的探讨孟鲁司特对间歇性哮喘急性发作期患儿嗜酸粒细胞(EOS)计数、白介素6(IL-6)的影响,并分析其与气道功能指标的相关性。方法选取2020—2022年黄骅市人民医院收治的间歇性哮喘急性发作期患儿130例,采用随机数字表法将其分为对照组和研究组,每组65例。入院后,所有患儿接受解痉、抗感染、平喘、吸氧、镇静等对症支持治疗,在此基础上,对照组患儿接受布地奈德治疗;在对照组基础上,研究组患儿接受孟鲁司特治疗。两组患儿治疗疗程为7 d,观察期为3周。比较两组临床疗效,治疗前及治疗7 d后气道炎症反应指标(EOS计数、IL-6)、肺功能指标〔最大流量峰值(PEF)、第1秒用力呼气容积(FEV_(1))占预计值百分比、FEV_(1)/用力肺活量(FVC)〕和气道功能指标〔最大呼气中期流速(MMEF)、用力呼出25%肺活量的呼气流速(MEF_(25))、用力呼出50%肺活量的呼气流速(MEF_(50))、用力呼出75%肺活量的呼气流速(MEF_(75))〕。对照组、研究组患儿EOS计数、IL-6与临床疗效、气道功能指标的相关性分析采用Spearman秩相关分析或Pearson相关分析。结果研究组总有效率为95.0%(57/60),高于对照组的83.3%(50/60)(P<0.05)。治疗7 d后,两组EOS计数、IL-6分别低于本组治疗前,且研究组EOS计数、IL-6低于对照组(P<0.05)。治疗7 d后,两组PEF分别快于本组治疗前,FEV_(1)占预计值百分比、FEV_(1)/FVC分别高于本组治疗前,且研究组PEF快于对照组,FEV_(1)占预计值百分比、FEV_(1)/FVC高于对照组(P<0.05)。治疗7 d后,两组MMEF、MEF_(25)、MEF_(50)、MEF_(75)分别大于本组治疗前,且研究组MMEF、MEF_(25)、MEF_(50)、MEF_(75)大于对照组(P<0.05)。Spearman秩相关分析或Pearson相关分析结果显示,在对照组、研究组患儿中,IL-6与临床疗效呈负相关,EOS计数、IL-6与MMEF、MEF_(25)、MEF_(50)、MEF_(75)呈负相关(P<0.05)。结论孟鲁司特可有效降低间歇性哮喘急性发作期患儿EObjective To investigate the effect of montelukast on eosinophil(EOS)count and interleukin-6(IL-6)in children with acute attack of intermittent asthma,and to analyze their correlation with airway function indexes.Methods A total of 130 children with acute attack of intermittent asthma admitted to Huanghua Municipal People's Hospital from 2020 to 2022 were selected and divided into control group and study group by random number table method,with 65 cases in each group.After admission,all patients received symptomatic and supportive treatment such as spasmolysis,anti-infection,asthma relief,oxygen inhalation and sedation.On this basis,the control group received budesonide.On the basis of the control group,the study group received montelukast.The treatment course of the two groups was 7 d,and the observation period was 3 weeks.The clinical efficacy,airway inflammatory response indexes(EOS count,IL-6),lung function indexes[peak expiratory flow(PEF),forced expiratory volume in one second(FEV_(1))percentage of predicted value,FEV_(1)/forced vital capacity(FVC)]and airway function indexes[maximal mid-expiratory flow(MMEF),forced expiratory flow at 25% of FVC exhaled(MEF_(25)),forced expiratory flow at 50% of FVC exhaled(MEF_(50)),forced expiratory flow at 75% of FVC exhaled(MEF_(75))]before treatment and at 7 days after treatment were compared between the two groups.Spearman rank correlation analysis or Pearson correlation analysis was used to analyze the correlation between EOS count,IL-6 and clinical efficacy and airway function indexes.Results The total effective rate of the study group was 95.0%(57/60),which was higher than 83.3%(50/60)of the control group(P<0.05).At 7 days after treatment,EOS count and IL-6 in the two groups were lower than those before treatment respectively,and EOS count and IL-6 in the study group were lower than those in the control group(P<0.05).At 7 days after treatment,the PEF of the two groups was faster than that before treatment,the FEV_(1) percentage of predicted value and FEV_(1)/FVC we

关 键 词：哮喘 间歇性哮喘 孟鲁司特 嗜酸粒细胞 白介素6 气道功能 

分 类 号：R256.12[医药卫生—中医内科学]