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目的:探讨孟鲁司特对哮喘患儿血浆白介素-5(IL-5)、白介素-10(IL-10)的水平及肺功能、气道反应性的影响。方法:选择80例哮喘急性发作期患儿,随机分为治疗组和对照组。治疗组在对照组常规吸入激素治疗的基础上,加用孟鲁司特片5 mg,po,qn,连用3个月。观察治疗前后哮喘患儿肺功能和气道反应性的变化,并检测血浆IL-5、IL-10和IgE水平的变化。结果:两组哮喘患儿治疗3月后肺功能指标FEV_1、PEF、FEF25和FEF50均较治疗前明显改善,且治疗组改善程度明显高于对照组;同时患儿气道对组胺的反应阈值Dmin明显升高,气道对组胺的反应性Rrsc降低。两组患儿治疗前血浆IL-5、IL-10和IgE水平比较无统计学差异,治疗3个月后血浆IL-5和IgE水平明显下降,IL-10水平明显上升。结论:孟鲁司特治疗哮喘的临床疗效确切,能明显降低患儿的气道高反应性和改善肺功能。作用机制可能是通过上调IL-10水平,下调IL-5水平,从而抑制嗜酸性粒细胞在气道聚集,减少IgE分泌,达到抑制气道炎症,缓解气道痉挛,降低气道高反应性,改善肺功能。
Objective: To investigate the effects of montelukast on plasma interleukin-5 (IL-5), interleukin-10 (IL-10) and pulmonary function and airway responsiveness in asthmatic children. Methods: Eighty children with acute asthma were randomly divided into treatment group and control group. The treatment group in the control group based on conventional inhaled hormone therapy, montelukast tablets plus 5 mg, po, qn, once every 3 months. The changes of lung function and airway responsiveness in children with asthma before and after treatment were observed, and the changes of plasma IL-5, IL-10 and IgE levels were also measured. Results: The pulmonary function indexes FEV_1, PEF, FEF25 and FEF50 of children with asthma in both groups after 3 months of treatment were significantly improved compared with those before treatment, and the improvement in the treatment group was significantly higher than that in the control group. At the same time, the response threshold of airway to histamine Dmin was significantly increased, airway responsiveness to histamine Rrsc decreased. The levels of plasma IL-5, IL-10 and IgE before treatment in both groups had no statistical difference. After 3 months of treatment, the levels of IL-5 and IgE in plasma and the level of IL-10 in the two groups were significantly increased. Conclusion: The clinical efficacy of montelukast in the treatment of asthma is accurate, which can significantly reduce airway hyperresponsiveness and improve pulmonary function in children. Mechanism may be through the upregulation of IL-10 levels, down-regulation of IL-5 levels, thereby inhibiting eosinophils in the airway aggregation, reduce IgE secretion, to inhibit airway inflammation, relieve airway spasm, reduce airway hyperresponsiveness, Improve lung function.