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目的观察孟鲁司特钠治疗后咳嗽变异性哮喘患儿血清肿瘤坏死因子α(tumor necrosis factor,TNF-α)、C反应蛋白(C-reactionprotein,CRP)及嗜酸性粒细胞(Eosinophils,EOS)水平变化,并探讨其临床意义。方法选择2015年2月—2016年8月收治的咳嗽变异性哮喘患儿81例,随机分为观察组41例、对照组40例。两组给予头孢呋辛酯、青霉素V钾片等抗感染,盐酸氨溴索、盐酸溴已新片等化痰止咳。观察组加孟鲁司特钠睡前口服,1~5岁患儿4 mg/d,>5岁患儿5 mg/d。两组均治疗8周。统计两组治疗总有效率;分别于治疗前及治疗4、8周测定血清TNF-α、CRP及外周血EOS水平。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组总有效率为92.68%,对照组为75.00%,比较差异有统计学意义(P<0.05)。与治疗前比较,治疗4、8周两组血清TNF-α、CRP及EOS水平均降低,比较差异有统计学意义(均P<0.05);治疗4、8周观察组血清TNF-α、CRP及EOS水平[(50.46±5.52)、(44.31±4.59)ng/L,(5.22±1.37)、(4.25±1.31)μmmol/L,(0.94±0.33)、(0.55±0.27)×10~9/L]低于对照组[(60.08±4.47)、(57.20±5.14)ng/L,(6.07±1.41)、(5.72±1.19)μmmol/L,(1.14±0.46)、(0.97±0.34)×10~9/L,比较差异有统计学意义(均P<0.05)。结论孟鲁司特钠治疗后咳嗽变异性哮喘患儿血清TNF-α、CRP及EOS水平均降低,孟鲁司特钠可能通过降低TNF-α、CRP及EOS水平发挥治疗作用。
Objective To observe the changes of serum tumor necrosis factor (TNF-α), C-reaction protein (C-reactive protein) and Eosinophils (EOS) in children with cough variant asthma after treatment with montelukast sodium Level changes, and explore its clinical significance. Methods Eighty-one children with cough variant asthma admitted from February 2015 to August 2016 were randomly divided into observation group (41 cases) and control group (40 cases). Two groups were given cefuroxime axetil, penicillin V potassium tablets and other anti-infection, ambroxol hydrochloride, bromhexine hydrochloride tablets and other phlegm and cough. The observation group plus montelukast sodium orally before going to bed, 4 mg / d in children aged 1 to 5 years, 5 mg / d in children> 5 years of age. Both groups were treated for 8 weeks. The total effective rate of two groups was calculated. Serum levels of TNF-α, CRP and peripheral blood EOS were measured before treatment and at 4 and 8 weeks respectively. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The total effective rate was 92.68% in the observation group and 75.00% in the control group, the difference was statistically significant (P <0.05). Compared with those before treatment, the levels of serum TNF-α, CRP and EOS in both groups decreased after 4 and 8 weeks of treatment, with significant difference (all P <0.05). After treatment for 4 and 8 weeks, serum levels of TNF-α and CRP (P <0.05), and the levels of EOS were significantly higher than those in the control group (50.46 ± 5.52, 44.31 ± 4.59 ng / L, 5.22 ± 1.37, 4.25 ± 1.31, 0.94 ± 0.33, L was significantly lower than that of the control group [(60.08 ± 4.47), (57.20 ± 5.14) ng / L, (6.07 ± 1.41), (5.72 ± 1.19) μmmol / L, (1.14 ± 0.46), (0.97 ± 0.34) ~ 9 / L, the difference was statistically significant (all P <0.05). Conclusion The levels of TNF-α, CRP and EOS in children with cough variant asthma after treatment with montelukast sodium are decreased. Montelukast may play a therapeutic role by decreasing the levels of TNF-α, CRP and EOS.