摘要
目的研究孟鲁司特对支气管哮喘急性发作期患儿外周血中CD4+CD25+调节性T细胞(Tregs)表达的影响及临床疗效。方法选取94例急性发作期的支气管哮喘患儿为研究对象,按随机数字表法将患儿分为对照组与观察组,每组47例。给予对照组患儿布地奈德混悬液0.5 mg/2 mL雾化吸入治疗,1次/d,连续治疗4周;观察组在此基础上加用孟鲁司特钠咀嚼片5 mg,1次/d,睡前口服,连用4周。酶联免疫吸附法(ELISA)检测患儿血清γ干扰素(IFN-γ)及血清白细胞介素-5(IL-5)水平,并进行日间、夜间症状评分,评价肺功能。采用流式细胞术分别对治疗前后患儿外周血中CD4+CD25+Tregs的表达水平进行检测。结果与治疗前相比,治疗后患儿的各项肺功能指标均改善良好,且相比于对照组,观察组的变化更显著,差异有统计学意义(P<0.05);在日间、夜间症状评分方面,与治疗前相比,两组患儿分数均呈下降趋势且观察组下降显著(P<0.05);治疗后患儿的IL-5水平均明显降低,IFN-γ水平均明显升高,且观察组变化程度更大(P<0.05);在CD4+CD25+Tregs表达方面,治疗后其表达水平均有所提高,观察组提高程度更大(P<0.05)。结论孟鲁司特能改善患儿肺功能及患儿哮喘日间、夜间症状评分,并通过上调CD4+CD25+Tregs比例,进而分泌表达IFN-γ、IL-5,达到抑制哮喘炎症反应的效果,是治疗治疗儿童急性支气管哮喘的有效药物。
Objective To investigate the clinical efficacy of montelukast on the treatment of children with acute bronchial asthma and its effect on the expression of CD4+CD25+regulatory T cells.Methods Ninety-four children with acute bronchial asthma from March 2016 to June 2017 were included and randomly divided into two groups,the conventional treatment group and montelukast group(n=47).Patients in conventional treatment group only inhaled budesonide suspension(0.5 mg/2 mL),while montelukast group was given with montelukast chewable(5 mg),with a treatment course of 4 weeks.The serum levels of IFN-γand IL-5 were assessed by ELISA.The day and night symptom scores were recorded.The pulmonary function before and after treatment were compared.The expression levels of CD4+CD25+Treg were observed by flow cytometry before and after treatment.Results After treatment,the lung function indexes of FVC,FEV1 and FEV1/FVC were significantly improved compared with those before treatment,and the improvement of the montelukast group was significantly more prominent(P<0.05).The levels of IFN-γin both groups were significantly higher than those before treatment;the levels of IL-5 were significantly lower than those before treatment;and the levels of IFN-γwere significantly higher than those before treatment;while these were significantly more prominent in montelukast group than conventional treatment group(P<0.05).The percentages of CD4+CD25+T cells in the two groups were significantly higher than those before treatment,and the percentage of CD4+CD25+T cells was significantly higher in montelukast group than conventional treatment group(P<0.05).Conclusion Montelukast can improve lung function,and day and night symptom scores.It increases CD4+CD25+T cells,up-regulates the expression of IFN-γand IL-5,thus inhibits inflammation of asthma.It is an effective drug for treatment of acute bronchial asthma in children.
作者
孙剑玥
解玉
徐亚娜
SUN Jian-yue;XIE Yü;XU Ya-na(Shanghai Putuo District Central Hospital(Putuo Hospital,Shanghai University of Traditional Chinese Medicine)Shanghai 200062,China)
出处
《广东医学》
CAS
2020年第12期1254-1258,共5页
Guangdong Medical Journal
基金
上海市卫计委中医薄弱专科建设项目(BRZK2016006)。
