孟鲁司特钠联合氨溴索对支气管哮喘患儿血清sE-SLT和sICAM-1水平的影响
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摘要
目的探讨孟鲁司特钠联合氨溴索对支气管哮喘患儿血清可溶性E-选择素(s E-SLT)、可溶性细胞间黏附分子-1(sICAM-1)水平的影响。方法前瞻性研究2014年3月至2017年3月宝鸡市人民医院收治的支气管哮喘患儿100例,按照随机数字表法将患儿分为孟鲁组和常规组,每组各50例,常规组给予常规对症和氨溴索治疗,孟鲁组在此基础上给予孟鲁司特钠治疗,比较两组患儿治疗前后血清sE-SLT、sICAM-1水平,肺功能[一秒钟用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC]和治疗疗效、不良反应情况。结果孟鲁组和常规组治疗后血清sE-SLT(220. 25±24. 19 pg/ml vs. 284. 34±29. 87pg/ml,256. 25±26. 65 pg/ml vs. 282. 77±28. 45 pg/ml)、sICAM-1(223. 54±15. 21 ng/ml vs. 277. 43±27. 67 ng/ml,245. 12±15. 75 ng/ml vs. 274. 45±28. 01 ng/ml)水平明显低于治疗前,孟鲁组治疗后血清sE-SLT、sICAM-1水平明显低于常规组,差异具有统计学意义(P <0. 05);孟鲁组和常规组治疗后FVC(3. 63±0. 51 L vs. 2. 76±0. 32 L,3. 34±0. 43 L vs. 2. 75±0. 42 L)、FEV1(2. 82±0. 42 L vs. 1. 93±0. 26 L,2. 53±0. 27L vs. 1. 94±0. 33 L)、FEV1/FVC(62. 01±7. 66 vs. 46. 67±5. 56,56. 28±6. 67 vs. 46. 32±5. 28)水平明显高于治疗前,孟鲁组治疗后FVCL、FEV、FEV1/FVC水平明显高于常规组,差异具有统计学意义(P <0. 05);孟鲁组治疗有效率为96. 00%,明显高于常规组的78. 00%,差异具有统计学意义(P <0. 05);孟鲁组和常规组的不良反应发生率为10. 00%、14. 00%基本相同,差异无统计学意义(P> 0. 05)。结论孟鲁司特钠联合氨溴索治疗可有效改善支气管哮喘患儿血清s E-SLT、sICAM-1水平和肺功能,有利于提高患儿的治疗疗效,且具有良好的安全性,值得临床推广应用。
Objective To explores the effect of Montelukast combined with Ambroxol on serum levels of sE-SLT and sICAM-1 in pediatric patients with bronchial asthma. Methods This is a prospective study,one hundred pediatric patients with bronchial asthma were selected during March 2014 to March 2017,according to random digital table method,all these patients were divided into Montelukast group( 50 cases)and control group( 50 cases),patients in control group were treated with routine symptomatic drugs and Ambroxol,patients in Montelukast group were treated with Montelukast on the basis of routine treatment. The serum levels of s E-SLT,sICAM-1 and lung functions [forced expiratory volume( FEV1),forced vital capacity( FVC),FEV1/FVC],therapeutic efficacy and adverse reactions were compared between these two groups before and after treatment. Results Atfter treatment,the serum levels of s E-SLT( 220. 25 ± 24. 19 pg/ml vs. 284. 34 ± 29. 87 pg/ml,256. 25± 26. 65 pg/ml vs. 282. 77 ± 28. 45 pg/ml) and sICAM-1( 223. 54 ± 15. 21 ng/ml vs. 277. 43 ± 27. 67 ng/ml,245. 12 ± 15. 75 ng/ml vs.274. 45 ± 28. 01 ng/ml) of Montelukast group and control group were significantly lower than those before treatment,the serum levels of s E-SLT and sICAM-1 in Montelukas group were significantly lower than those of control group,and the difference was statistically significant( P < 0.05). The serum levels of FVC( 3. 63 ± 0. 51 L vs. 2. 76 ± 0. 32 L,3. 34 ± 0. 43 L vs. 2. 75 ± 0. 42 L),FEV1( 2. 82 ± 0. 42 L vs. 1. 93 ± 0. 26 L,2. 53 ± 0. 27 L vs. 1. 94 ± 0. 33 L),FEV1/FVC( 62. 01 ± 7. 66 vs. 46. 67 ± 5. 56,56. 28 ± 6. 67 vs. 46. 32 ± 5. 28) in Montelukast group and control group were significantly higher than those before treatment,and the serum levels of FVC,FEV1,FEV1/FVC in Montelukas group were significantly higher than those of control group,and the difference was statistically significant( P < 0. 05). The effective rate of treatment in Montelukast group was 96. 00%,which was significantly higher than that of conventional group( 78. 00%),and the difference was statistically significant( P < 0. 05). The rate of adverse reactions in Montelukast group was 10. 00% and 14. 00% in control group,it was basically the same,and the difference was not statistically significant( P > 0. 05). Conclusion Montelukast combined with Ambroxol can effectively raise the serum levels of s E-SLT,sICAM-1 and lung function in pediatric patients with bronchial asthma,it's worthy to be applied for further clinical application.It is helpful to raise the curative effect of these pediatric patients with good safety,hence it is worthy to be for further clinical promotion.
Objective To explores the effect of Montelukast combined with Ambroxol on serum levels of sE-SLT and sICAM-1 in pediatric patients with bronchial asthma. Methods This is a prospective study,one hundred pediatric patients with bronchial asthma were selected during March 2014 to March 2017,according to random digital table method,all these patients were divided into Montelukast group( 50 cases)and control group( 50 cases),patients in control group were treated with routine symptomatic drugs and Ambroxol,patients in Montelukast group were treated with Montelukast on the basis of routine treatment. The serum levels of s E-SLT,sICAM-1 and lung functions [forced expiratory volume( FEV1),forced vital capacity( FVC),FEV1/FVC],therapeutic efficacy and adverse reactions were compared between these two groups before and after treatment. Results Atfter treatment,the serum levels of s E-SLT( 220. 25 ± 24. 19 pg/ml vs. 284. 34 ± 29. 87 pg/ml,256. 25± 26. 65 pg/ml vs. 282. 77 ± 28. 45 pg/ml) and sICAM-1( 223. 54 ± 15. 21 ng/ml vs. 277. 43 ± 27. 67 ng/ml,245. 12 ± 15. 75 ng/ml vs.274. 45 ± 28. 01 ng/ml) of Montelukast group and control group were significantly lower than those before treatment,the serum levels of s E-SLT and sICAM-1 in Montelukas group were significantly lower than those of control group,and the difference was statistically significant( P < 0.05). The serum levels of FVC( 3. 63 ± 0. 51 L vs. 2. 76 ± 0. 32 L,3. 34 ± 0. 43 L vs. 2. 75 ± 0. 42 L),FEV1( 2. 82 ± 0. 42 L vs. 1. 93 ± 0. 26 L,2. 53 ± 0. 27 L vs. 1. 94 ± 0. 33 L),FEV1/FVC( 62. 01 ± 7. 66 vs. 46. 67 ± 5. 56,56. 28 ± 6. 67 vs. 46. 32 ± 5. 28) in Montelukast group and control group were significantly higher than those before treatment,and the serum levels of FVC,FEV1,FEV1/FVC in Montelukas group were significantly higher than those of control group,and the difference was statistically significant( P < 0. 05). The effective rate of treatment in Montelukast group was 96. 00%,which was significantly higher than that of conventional group( 78. 00%),and the difference was statistically significant( P < 0. 05). The rate of adverse reactions in Montelukast group was 10. 00% and 14. 00% in control group,it was basically the same,and the difference was not statistically significant( P > 0. 05). Conclusion Montelukast combined with Ambroxol can effectively raise the serum levels of s E-SLT,sICAM-1 and lung function in pediatric patients with bronchial asthma,it's worthy to be applied for further clinical application.It is helpful to raise the curative effect of these pediatric patients with good safety,hence it is worthy to be for further clinical promotion.
引文
[1]冯湘平,赵辉,陆强.支气管哮喘病因和发病机制的研究进展[J].国际呼吸杂志,2013,33(15):1170-1173.
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[3]刘振冬,郑志新.氨茶碱联合盐酸氨溴索治疗小儿支气管哮喘临床效果[J].临床医学研究与实践,2017,2(21):94-95.
[4]武彩虹,银广悦,钱成荣,等.血清粘附分子SE-CAD、SE-SEL和s ICAM-1在肺癌诊断中的应用[J].临床输血与检验,2017,19(4):382-385.
[5]刘越,张改改,傅羽,等.克山病合并高血压患者血浆可溶性黏附因子-1和可溶性E-选择素的临床观察[J].中华地方病学杂志,2016,35(4):306-309.
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[7]徐唐星,陈小坤,陈小娟,等.老年支气管哮喘患者应用硫酸镁联合孟鲁司特钠治疗的疗效分析[J].数理医药学杂志,2017,30(1):84-86.
[8]刘力兴,贾钦尧.支气管哮喘患者外周血单个核细胞NLRP3mRNA和血清IL-18、IL-1β的表达和研究[J].临床和实验医学杂志,2016,15(4):345-347.
[9]Baena-Cagnani CE,Teijeiro A,Canonica GW.Four-year followup in children with moderate/severe uncontrolled asthma after withdrawal of a 1-year omalizumab treatment[J].Curr Opin Allergy Clin Immunol,2015,15(3):267-271.
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[11]林文燕.氨茶碱联合孟鲁司特钠治疗支气管哮喘的疗效观察[J].广西医科大学学报,2017,34(8):1197-1200.
[12]雷玉琳.氨溴特罗口服溶液联合孟鲁司特钠咀嚼片治疗儿童急性支气管炎的临床效果[J].中国医药导报,2017,14(6):124-127.
[13]张静玉,王彦辉,张明亮.多索茶碱与盐酸氨溴索联合治疗支气管哮喘急性期患者的临床疗效观察[J].西北药学杂志,2016,31(2):192-194.
[14]陈节,孙红梅.肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J].临床肺科杂志,2017,22(3):464-467.
[15]周洁,黄星原,魏丽,等.半胱氨酰白三烯受体拮抗剂在心血管疾病中的研究进展[J].职业与健康,2017,33(4):569-572.
[16]贺立群,雷健,王顺,等.他汀治疗对冠状动脉慢血流患者血清可溶性E-选择素、hs-CRP水平的影响[J].内科急危重症杂志,2014,20(5):313-314.
[17]曾洁敏,冯浩然,黄萍,等.小儿主动脉缩窄血压血清可溶性E-选择素变化及其意义研究[J].中国实用儿科杂志,2015,30(12):921-924.
[18]李玲,万欢.孟鲁司特钠片联合硫酸镁注射液治疗老年支气管哮喘临床疗效观察[J].实用老年医学,2015,29(7):577-579.
[19]Tsaur I,Thurn K,Juengel E,et al.s E-cadherin serves as a diagnostic and predictive parameter in prostate cancer patients[J].J Exp Clin Cancer Res,2015,34:43.
[2]Moy ML,Teylan M,Weston NA,et al.Daily step count is associated with plasma C-reactive protein and IL-6 in a US cohort with COPD[J].Chest,2014,145(3):542-550.
[3]刘振冬,郑志新.氨茶碱联合盐酸氨溴索治疗小儿支气管哮喘临床效果[J].临床医学研究与实践,2017,2(21):94-95.
[4]武彩虹,银广悦,钱成荣,等.血清粘附分子SE-CAD、SE-SEL和s ICAM-1在肺癌诊断中的应用[J].临床输血与检验,2017,19(4):382-385.
[5]刘越,张改改,傅羽,等.克山病合并高血压患者血浆可溶性黏附因子-1和可溶性E-选择素的临床观察[J].中华地方病学杂志,2016,35(4):306-309.
[6]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志,2016,39(9):675-697.
[7]徐唐星,陈小坤,陈小娟,等.老年支气管哮喘患者应用硫酸镁联合孟鲁司特钠治疗的疗效分析[J].数理医药学杂志,2017,30(1):84-86.
[8]刘力兴,贾钦尧.支气管哮喘患者外周血单个核细胞NLRP3mRNA和血清IL-18、IL-1β的表达和研究[J].临床和实验医学杂志,2016,15(4):345-347.
[9]Baena-Cagnani CE,Teijeiro A,Canonica GW.Four-year followup in children with moderate/severe uncontrolled asthma after withdrawal of a 1-year omalizumab treatment[J].Curr Opin Allergy Clin Immunol,2015,15(3):267-271.
[10]Pijnenburg MW,Baraldi E,Brand PL,et al.Monitoring asthma in children[J].Eur Respir J,2015,45(4):906-925.
[11]林文燕.氨茶碱联合孟鲁司特钠治疗支气管哮喘的疗效观察[J].广西医科大学学报,2017,34(8):1197-1200.
[12]雷玉琳.氨溴特罗口服溶液联合孟鲁司特钠咀嚼片治疗儿童急性支气管炎的临床效果[J].中国医药导报,2017,14(6):124-127.
[13]张静玉,王彦辉,张明亮.多索茶碱与盐酸氨溴索联合治疗支气管哮喘急性期患者的临床疗效观察[J].西北药学杂志,2016,31(2):192-194.
[14]陈节,孙红梅.肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J].临床肺科杂志,2017,22(3):464-467.
[15]周洁,黄星原,魏丽,等.半胱氨酰白三烯受体拮抗剂在心血管疾病中的研究进展[J].职业与健康,2017,33(4):569-572.
[16]贺立群,雷健,王顺,等.他汀治疗对冠状动脉慢血流患者血清可溶性E-选择素、hs-CRP水平的影响[J].内科急危重症杂志,2014,20(5):313-314.
[17]曾洁敏,冯浩然,黄萍,等.小儿主动脉缩窄血压血清可溶性E-选择素变化及其意义研究[J].中国实用儿科杂志,2015,30(12):921-924.
[18]李玲,万欢.孟鲁司特钠片联合硫酸镁注射液治疗老年支气管哮喘临床疗效观察[J].实用老年医学,2015,29(7):577-579.
[19]Tsaur I,Thurn K,Juengel E,et al.s E-cadherin serves as a diagnostic and predictive parameter in prostate cancer patients[J].J Exp Clin Cancer Res,2015,34:43.