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目的:通过检测炎症因子白介素-5(interleukin-5)和嗜酸粒细胞趋化蛋白(Eotaxin)的变化及呼吸道合胞病毒(RSV)毛细支气管炎(毛支)后3月内的喘息情况,探讨孟鲁司特对RSV毛支后气道炎症的干预作用。方法:选择88例初次喘息发作的具有特应性体质的患儿作为研究对象,40例毛支患儿为对照组予常规治疗,48例在常规治疗的同时口服孟鲁司特钠为观察组。分别在急性期及恢复期检测血清IL-5及Eotaxin水平的变化,门诊随访3月,观察有无喘息再次发作。结果:RSV毛支患儿急性期血清IL-5及Eotaxin水平明显增高,经孟鲁司特干预后,恢复期IL-5及Eotaxin水平明显下降。3个月内喘息再次发作人数比较两组差异有统计学意义(P<0.01)。结论:RSV毛支患儿急性期炎症因子IL-5及Eotaxin水平明显增高,孟鲁司特对RSV毛支IL-5和Eotaxin有下调作用,可控制RSV毛细支气管炎后的气道炎症,对毛支后喘息的反复发作具有预防作用。
OBJECTIVE: To detect wheezing within 3 months after the change of inflammatory factors interleukin-5 and eotaxin and respiratory syncytial virus (RSV) bronchiolitis (bronchiitis) To investigate the intervention effect of montelukast on airway inflammation of RSV bronchiolitis. Methods: Eighty-eight infants with atopic wheezing who had first wheezing episodes were enrolled in this study. Forty patients with bronchiolitis were treated as control group, and 48 were treated with montelukast sodium as control group . Serum levels of IL-5 and Eotaxin were detected in acute phase and convalescent phase respectively. Outpatients were followed up for 3 months to observe whether there was a resumption of wheezing. Results: Serum levels of IL-5 and Eotaxin were significantly increased in acute RSV bronchiolitis patients. After montelukast intervention, the levels of IL-5 and Eotaxin in convalescent rats decreased significantly. There was a significant difference between the two groups in the number of recurrent wheezing within 3 months (P <0.01). Conclusion: The levels of inflammatory cytokines IL-5 and Eotaxin are significantly increased in children with RSV bronchiolitis, and montelukast may down-regulate IL-5 and Eotaxin of bronchial epithelial cells of RSV, which can control airway inflammation after RSV bronchiolitis. Repeated hair wheezing wheezing has a preventive effect.