孟鲁司特佐治过敏性紫癜的临床疗效及对炎症因子的影响

目的 探讨孟鲁司特辅佐治疗过敏性紫癜的临床效果及对细胞因子白细胞介素(IL)-17、IL-9表达的影响.方法 选取30例健康儿童作为对照组,60例过敏性紫癜患儿作为实验组.实验组随机分为A、B组,各30例,A组在常规综合治疗的基础上给予口服孟鲁司特治疗,B组仅给予常规治疗.比较A、B两组患儿疗效,并采用ELISA检测实验组治疗前后及健康对照组中患儿IL-17 、IL-9水平的表达.结果 A组皮疹消退、消化道、关节及肾脏症状缓解时间明显短于B组,复发率低于B组,总有效率高于B组,两两比较,差异均有具有统计学意义(t=1.843、2.432、2.063、1.976,x2=4.356,x2 =7.521,均P＜0.05).实验组A、B两组外周血IL-17 、IL-9表达水平均较健康对照组明显升高,差异具有统计学意义(t=17.241、16.981,6.023、9.986,均P＜0.05);实验组A、B两组外周血IL-17、IL-9表达水平均较治疗前降低,A组降低更明显,差异具有统计学意义(t=16.747、10.618,5.836、4、646,均P＜0.05).结论 IL-17、IL-9参与了过敏性紫癜(HSP)的发生发展;口服孟鲁司特较单纯常规治疗可明显降低细胞因子的表达水平,缩短症状消失的时间,减少复发率,临床疗效显著,值得在临床上推广使用.

The clinical effect of montelukast on Henoch-Sch(o)nlein purpura and the expression of inflammatory factots cytokines during treatment

Objective To investigate the clinical efficacy of montelukast on Henoch-Schonlein Purpura and to explore the relationship of the concentration levels of interleukin (IL)-17 and IL-9 in Henoch-Schonlein Purpura.Methods 30 were taken as the control subjects,60 were taken as the subjects of treatment patients with Henoch-Schonlein Purpura.The treated subjects were divided into group A and B randomly.A group (30 cases) was treated with the conventional medication and montelukast.B group (30 cases) was only treated with conventional medication.The clinical effects of the two groups were compared and Levels of IL-17 and IL-9 were detected by ELISA.Results Compared with group B,when the rashes subsided in group A,its symposiums in digestive tracts,joints and kidneys were alleviated significantly slower;the reoccurrence rate is lower;and the total effective rate is higher.According to the comparision between the two groups,the difference is of statistical significance(t =1.843,2.432,2.063,1.976,x2 =4.356,x2 =7.521,P ＜ 0.05).IL-17 and IL-9 levels in the peripheral blood of A and B were higher than the control group significantly(t =17.241,16.981,6.023,9.986,P ＜ 0.05);After treatment,the levels of IL-1 7 and IL-9 were all decreased in tested group,but A group decreased more obviously (t =16.747,10.618,5.836,4、646,P ＜ 0.05).Conclusions IL-17 and IL-9 are involved in the development of HSP.Montelukast plus conventional medication can obviously shorten the recovery time of symptoms and reduce the recurrence rate.It have a remarkable effect on the clinical application and is worth using in clinical practice.