孟鲁司特钠对小儿毛细支气管炎TH17/Treg的调节作用及疗效研究

目的：观察孟鲁司特钠对小儿毛细支气管炎Th17/Treg的调节作用及疗效。方法：选取2013年6月至2015年4月我院儿科治疗的毛细支气管炎患儿124例，随机分为对照组和观察组各62例。对照组给予常规综合治疗，包括吸氧、利巴韦林抗病毒、沙丁胺醇气雾剂平喘、合并细菌感染时抗感染、氯丙嗪镇静等；观察组在对照组治疗基础上加用孟鲁司特钠片4 mg/d，每天睡前顿服，连续治疗7 d。流式细胞仪检测Th17和Treg细胞水平，ELISA法测定IL-17和IL-10表达水平，评价疗效。结果：治疗前，两组Th17、Treg、IL-17、IL-10水平比较差异无统计学意义（P均>0.05）；治疗后，两组Th17、IL-17水平均降低且观察组低于对照组，Treg、IL-10水平均升高且观察组高于对照组（P均<0.05）。观察组总有效率90.32%，高于对照组的72.58%，且症状消失时间和住院时间均短于对照组（P均<0.05）。结论：孟鲁司特钠可以调节毛细支气管炎患儿体内Th17/Treg平衡，对小儿毛细支气管炎具有一定的临床应用价值。

The Effect of Montelukast on Th17/Treg Balance in Children with Bronchioliti and Its Clinical Efficacy

Objective: To detect the effect of montelukast on Th17/Treg balance in children with bronchioliti and explore its clinical efficacy. Methods: A total of 124 children with bronchioliti were enrolled in this study. Children were randomly divided into control group (n=62) and observation group (n=62). The Th17 and Treg cells were detected by cytometry analysis. The expression of IL-17 and IL-10 were detected by ELISA analysis. The clinical effect of the two groups was compared. Results: Before treatment, Th17 cells, Treg cells, IL-17, and IL-10 was no significant difference between the two groups (P>0.05). After treatment, Th17 cells and IL-17 was decreased and Treg cells and IL-10 was increased in the two groups (P<0.05). However, the improvement was better in observation group than that in control group (P<0.05). The disappearance time of coughing, wheezing, pulmonary rales and hospital duration was significantly higher than that of observation group (P<0.05). The clinical effective rate of was 72.6% in control group, which was significantly lower than that of 90.3% in observation group (P<0.05). Conclusion: Montelukast could regulate Th17/Treg cells immune balance in children with bronchioliti, with worthy of clinical application.