布地奈德联合西替利嗪治疗小儿哮喘对血清解整合素-金属蛋白酶33及1-磷酸鞘氨醇水平的影响

目的:探讨布地奈德联合西替利嗪治疗小儿哮喘对血清解整合素-金属蛋白酶33(ADAM33)及1-磷酸鞘氨醇(S1P)水平的影响。方法:选择2014年6月至2017年9月我院收治的100例支气管哮喘患儿为研究对象,按随机数字表法分为研究组和对照组各50例。对照组给予布地奈德气雾剂雾化吸入治疗,研究组在对照组的基础上给予西替利嗪治疗。分析比较两组临床疗效、临床症状消失时间及不良反应发生情况,监测治疗前后肺功能、血清炎症因子和ADAM33、S1P水平变化。结果:研究组治疗有效率为92.0%,高于对照组的72.0%(P<0.05)。研究组治疗后哮鸣音、咳嗽、呼吸困难消失时间和住院时间均明显短于对照组(P<0.05)。治疗后两组患儿的FEV1、PEF水平均显著增加,且研究组FEV1、PEF水平高于对照组(P<0.05)。治疗后研究组患儿的IL-6和TNF-α的水平低于对照组(P<0.05),研究组血清ADAM33及S1P低于对照组(P<0.05)。对照组不良反应发生率为14.0%,观察组为18.0%,两组比较差异无统计学意义(P>0.05)。结论:布地奈德气雾剂雾化吸入联合西替利嗪能有效改善支气管哮喘患儿临床症状,提高患儿肺功能,降低血清ADAM33及S1P水平,缓轻炎症损伤,改善气道重塑,且安全性较好。

Effects of Budesonide Combined with Cetirizine on Serum a Disintegrin and Metalloprotease 33 and Sphingosine-1-Phosphate Levels in Children with Asthma

Objective:To explore the effects of budesonide combined with cetirizine on serum a disintegrin and metalloprotease 33(ADAM33)and sphingosine-1-phosphate(S1P)levels in children with asthma.Methods:Totally 100 children with bronchial asthma admitted into our hospital from Jun.2014 to Sept.2017 were extracted to be divided into the study group and the control group via the random number table,with 50 cases in each group.The control group was given budesonide aerosol inhalation,while the study group additionally received cetirizine on the basis of the control group.The clinical efficacy,disappearance time of clinical symptoms and adverse drug reactions of two groups were compared.Changes of pulmonary function,serum inflammatory factors,ADAM33 and S1P levels of two groups were recorded.Results:The total effective rate of the study group was 92.0%,higher than 72.0%of the control group(P<0.05).The disappearance time of wheezing,cough and dyspnea,length of stay in the study group were significantly shorter than those in the control group(P<0.05).After treatment,the levels of FEV1 and PEF in two groups increased significantly,and the levels of FEV1 and PEF in the study group were higher than those in the control group(P<0.05).After treatment,the levels of IL-6 and TNF-αin the study group were lower than those in the control group(P<0.05),and serum ADAM33 and S1P in the study group were lower than those in the control group(P<0.05).The incidence of adverse drug reactions was 14.0%in the control group and 18.0%in the observation group,with no statistically significant difference between two groups(P>0.05).Conclusion:Budesonide aerosol inhalation combined with cetirizine can effectively improve the clinical symptoms and the pulmonary function of children with bronchial asthma,reduce the levels of ADAM33 and S1P,release the inflammation injury and improve airway remodeling with higher safety.