孟鲁司特对儿童咳嗽变异性哮喘患者血清炎症因子调节及疗效观察.doc

孟鲁司特对儿童咳嗽变异性哮喘患者血清炎症因子调节及疗效观察 　　[摘要] 目的 探讨孟鲁司特对儿童咳嗽变异性哮喘患者血清炎症因子的调节及疗效观察。 方法 将86例儿童CVA随机分为孟鲁司特组（n=43）和对照组（n=43）。对照组予以口服酮替芬片0.5 mg/次，2次/d；连用10周；孟鲁司特组予以口服孟鲁司特钠咀嚼片5 mg/次，1次/d，连用10周。观察并记录两组患儿治疗前后血清超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）和白介素-10（IL-10）水平的变化，并比较其治疗后的临床效果及药物不良反应。 结果 治疗10周后，两组患儿的血清hs-CRP、TNF-α水平均有不同程度下降，血清IL-10水平均不同程度上升（P0.01或P0.05），且孟鲁司特组下降或上升幅度较对照组更明显（P0.05）；同时孟鲁司特组的临床总有效率（95.35%）明显高于对照组（79.07%）（χ2=4.16，P0.05），两组患儿治疗中未发生明显药物不良反应。结论 孟鲁司特用于治疗儿童CVA的疗效较显著，安全性较佳，其机制与孟鲁司特能降低血清促炎症因子hs-CRP、TNF-α水平，提高血清抗炎症因子IL-10水平，从而纠正患儿血清炎症因子网络紊乱，抑制气道炎症介质的释放，控制儿童CVA发作。 　　[关键词] 咳嗽变异性哮喘；孟鲁司特；超敏C反应蛋白；肿瘤坏死因子-α；白介素-10 　　[中图分类号] R725.6 [文献标识码] B [文章编号] 1673-9701（2015）04-0064-03 　　[Abstract] Objective To discuss curative effect of montelukast on children with cough variant asthma（CVA） and its effect on serum inflammatory factors in children. Methods A total of 86 cases of children with CVA were divided into montelukast group（n=43） and control group （n=43） at random. The children in control group were given oral Chloperastine， 0.5 mg per time， twice a day for 10 weeks， while the children in montelukast group were given oral montelukast Dulcet， 5mg per time， once a day， for 10 weeks. The changes of serum high sensitivity C-reactive protein（hs-CRP）， tumor necrosis factor-α（TNF-α） and interleukin-10（IL-10） levels of children in two groups before and after medical treatment were observed and recorded， and the clinical curative effect and drug adverse reaction（DAR） after the medical treatment were compared as well. Results After 10 weeks’medical treatment， serum hs-CRP and TNF-α levels of children in two groups were declined with different degrees， while serum IL-10 level were rose with different degrees（P0.01 or P0.05）， and the declining or rising rates of children in montelukast group were much higher than those in control group （P0.05）. Meanwhile， the total clinical efficiency of children in montelukast group（95.35%） was much higher than that in control group （79.07%） （χ2=4.16， P0.05）. No obv