孟鲁司特钠治疗咳嗽变异性哮喘患儿的近远期临床效果及对血清炎性因子的影响

目的:探讨孟鲁司特钠治疗咳嗽变异性哮喘患儿的近期及远期临床效果,以及对血清血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和免疫球蛋白E(IgE)水平的影响.方法:选择合适的患儿80例,随机分为观察组和对照组各40例,均给予常规治疗,对照组加用丙酸倍氯米松吸入气雾剂,观察组加用孟鲁司特钠咀嚼片,连续治疗3个月,评价临床治疗效果,测定治疗前后血清TNF-α、IL-8、IL-10和IgE水平.结果:观察组患儿临床控制21例、显效9例、有效7例和无效3例,总有效率75.00%;对照组临床控制13例、显效8例、有效13例和无效6例,总有效率52.50%,差异有统计学意义(P<0.05).观察组患儿咳嗽、咽痛、喉痒常见症状消失时间早于对照组,差异有统计学意义(P<0.05).治疗前,两组患儿血清TNF-α、IL-8、IL-10和IgE水平相似,差异无统计学意义(P>0.05);治疗结束,两组患儿血清TNF-α、IL-8、IL-10和IgE水平较治疗前均改善,而观察组改善幅度更显著,差异有统计学意义(P<0.05).治疗结束后1年,观察组患儿累积复发7例,复发率17.50%;对照组累积复发14例,复发率35.00%,差异有统计学意义(P<0.05).结论:孟鲁司特钠治疗咳嗽变异性哮喘患儿具有较好的近期临床治疗效果,缩短患儿症状改善时间,减轻机体炎症反应,降低远期复发率.

Short and Long-term Clinical Efficacy of Montelukast Sodium in the Treatment of Cough Variant Asthma and the Effect on Serum Inflammatory Factors in Children

Objective:To investigate the short and long-term clinical efficacy of montelukast sodium in the treatment of cough variant asthma and the effects on serum levels of tumor necrosis factor -α ( TNF-α) , interleukin-8 ( IL-8) , interleukin-10 ( IL-10) , and immune globulin E ( IgE) in children. Methods: To-tally 80 eligible children were selected, and randomly divided into observation group and control group, with 40 children in each group. Both groups were given conventional therapies, and beclometasone dipropionate in-halation aerosol was used additionally to the control group, while montelukast sodium chewable tablets was used additionally to the observation group, both used successively for 3 months. The clinical efficacy was as-sessed, and the serum levels of TNF-α, IL-8, IL-10, and IgE were determined before and after treatment. Results:In the observation group, 21 children were clinically controlled, of which 9 were responsive to the therapy excellently, 7 were responsive to the therapy, and 3 were unresponsive to the therapy,so the overall response rate was 75.00%;while in the control group, 13 children were clinically controlled, of which 8 were responsive to the therapy excellently, 13 were responsive to the therapy, and 6 were unresponsive to the thera-py, so the overall response rate was 52.50%. The differences were statistically significant ( P<0.05) . The dis-appearance time of common symptoms such as cough, angina, and itching throat in the observation group were significantly shorter than those in the control group ( P<0.05) . Before the treatment, the serum level of TNF-α, IL-8, IL-10, and IgE were similar in two groups, the difference was statistically insignificant ( P >0. 05);After treatment, the serum level of TNF-α, IL-8, IL-10, and IgE were significantly improved in both groups compared with those before treatment, while the improving extents in the observation group were greater than those in the control group, the difference was statistically significant (P<0.05). 1 year after the treat-ment, totally 7 children of the observation group experienced relapse and the relapse rate was 17.50%;while totally 14 children experienced relapse and the relapse rate was 35.00%; and the difference was statistically significant ( P<0.05) . Conclusion:In the treatment of cough variant asthma in children, Montelukast sodium has good short-term clinical efficacy, and can shorten the symptomatic improvement time, lighten the inflam-matory reactions, and reduce the long-term relapse rate.