布地奈德雾化吸入联合孟鲁司特对支气管哮喘患儿呼吸道功能及血清TGF-β2和IL-17水平的影响
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摘要
目的观察布地奈德雾化吸入联合孟鲁司特对支气管哮喘患儿的呼吸道功能及血清转化生长因子-β2(TGF-β2)和白介素-17(IL-17)水平的影响。方法收集就诊的临床诊断为支气管哮喘患儿160例,随机分为观察组和对照组,每组80例。观察组采用布地奈德雾化吸入联合孟鲁司特治疗,对照组采用布地奈德雾化吸入治疗,对2组患儿治疗前后的肺功能、血清TGF-β2和IL-17水平进行比较,并比较2组的临床疗效及不良反应发生情况。结果 2组患儿的FVC、FEV1和PEF值较治疗前升高,而血清TGF-β2和IL-17水平较治疗前下降,且治疗后观察组的FVC、FEV1和PEF值较对照组高,TGF-β2和IL-17水平较对照组低,差异均有统计学意义(P<0.05)。观察组的临床总有效率为95.0%高于对照组的85.0%,差异有统计学意义(P<0.05);观察组的总不良反应发生率为7.5%与对照组的5.0%比较差异无统计学意义(P>0.05)。结论布地奈德雾化吸入联合孟鲁司特片治疗可有效提高支气管哮喘患儿的临床疗效,改善患者的肺功能,降低血清TGF-β2和IL-17水平,且安全性较高,值得推广应用。
Objective To observe the effects of budesonide atomization inhalation combined with montelukast on pulmonary function,serum levels of TGF-β2 and IL-17 in children with bronchial asthma.Methods A total of 160 children who were diagnosed as bronchial asthma,were randomly divided into observation group(n=80) and control group(n=80).The patients in observation group were treated by budesonide atomization inhalation combined with montelukast,however,the patients in in control group were treated by budesonide atomization inhalation only.The lung function,serum levels of TGF-β2 and IL-17 of the patients in both groups before and after treatment were compared.Moreover,the therapeutic effects and adverse reactions were observed and compared between the two groups.Results After treatment,the levels of FVC,FEV1 and PEE in both groups were increased,however,the the serum levels of TGF-β2 and IL-17 were decreased.The levels of FVC,FEV1 and PEE in observation group were significantly higher than those in control group,however,the serum levels of TGF-β2 and IL-17 in observation group were significantly lower than those in control group(P<0.05).Moreover,the total effective rate in observation group(95.0%) was significantly higher than that(85.0%) in control group(P<0.05).In addition,there was no significant difference in the total incidence rate of adverse reactions between observation group and control group(7.5% vs 5.0%,P > 0.05).Conclusion The budesonide atomization inhalation combined with montelukast can effectively improve the clinical curative effects on bronchial asthma in children,improve lung function and reduce serum levels of TGF-β2 and IL-17,with higher safety,which is worth using widely in clinical practice.
Objective To observe the effects of budesonide atomization inhalation combined with montelukast on pulmonary function,serum levels of TGF-β2 and IL-17 in children with bronchial asthma.Methods A total of 160 children who were diagnosed as bronchial asthma,were randomly divided into observation group(n=80) and control group(n=80).The patients in observation group were treated by budesonide atomization inhalation combined with montelukast,however,the patients in in control group were treated by budesonide atomization inhalation only.The lung function,serum levels of TGF-β2 and IL-17 of the patients in both groups before and after treatment were compared.Moreover,the therapeutic effects and adverse reactions were observed and compared between the two groups.Results After treatment,the levels of FVC,FEV1 and PEE in both groups were increased,however,the the serum levels of TGF-β2 and IL-17 were decreased.The levels of FVC,FEV1 and PEE in observation group were significantly higher than those in control group,however,the serum levels of TGF-β2 and IL-17 in observation group were significantly lower than those in control group(P<0.05).Moreover,the total effective rate in observation group(95.0%) was significantly higher than that(85.0%) in control group(P<0.05).In addition,there was no significant difference in the total incidence rate of adverse reactions between observation group and control group(7.5% vs 5.0%,P > 0.05).Conclusion The budesonide atomization inhalation combined with montelukast can effectively improve the clinical curative effects on bronchial asthma in children,improve lung function and reduce serum levels of TGF-β2 and IL-17,with higher safety,which is worth using widely in clinical practice.
引文
1曹欣,刘章华,任加红.吸入性沙美特罗替卡松联合孟鲁司特钠治疗儿童支气管哮喘的临床分析.医学综述,2018,24:3728-3732.
2莫丽慧,钟丽花.孟鲁司特联合布地奈德治疗支气管哮喘患儿的临床观察.中国药房,2017,28:1981-1984.
3于庆丰,季小玲,张宪涛.孟鲁司特联合布地奈德雾化吸入对支气管哮喘患者肺功能及血清嗜酸粒细胞阳离子蛋白、转化生长因子-β1水平的影响.实用心脑肺血管病杂志,2018,26:142-144.
4 Vijayakumar J,Subramanian S,Singh P,et al.Arterial inflammation in bronchial asthma.J Nucl Cardiol,2013,20:385-395.
5欧婧岚,汤华.布地奈德雾化吸入联合孟鲁司特钠对支气管哮喘患儿肺功能及CysLTs、FLAPmRNA表达的影响.现代医学,2017,45:1127-1130.
6刘传合,陈育智.儿童哮喘流行病学及防治现状分析.中国实用儿科杂志,2013,28:809-811.
7中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版).中华儿科杂志,2016,54:167-181.
8赵红丽.布地奈德联合孟鲁司特钠治疗支气管哮喘患儿的临床疗效和安全性.中国现代药物应用,2013,7:131-132.
9陈碧芬,王建雄,江铁成,等.儿童哮喘气道功能变化研究.中国临床医师杂志,2016,44:89-91.
10张佳佳,胡赤军,周小勤,等.布地奈德联合孟鲁司特钠对支气管哮喘患儿细胞因子、免疫功能影响.现代生物医学进展,2017,17:550-553.
11白润娥,李奴旺,高建萍.布地奈德联合孟鲁司特钠对支气管哮喘患儿细胞因子免疫功能的影响.中国药物与临床,2018,18:1360-1362.
12 Boyce JA,Barrett NA.Cysteinyl leukotrienes:an innate system for epithelial control of airway smooth muscleproliferation.Am J Resp Crit Care,2015,191:496-497.
13李秀莲.布地奈德联合孟鲁司特钠对支气管哮喘患儿临床疗效的影响分析.大家健康(学术版),2016,10:12-13.
14郑贵浪,吴家兴.孟鲁司特治疗儿童支气管哮喘的临床疗效及肺功能和细胞因子变化研究.中国全科医学,2015,18:1387-1389.
15张子友,朱厚才,杨先文,等.孟鲁司特片联合布地奈德雾化吸入治疗对儿童支气管哮喘呼吸道功能及血清IL-17、TGF-β2水平的影响.湖南师范大学学报(医学版),2018,15:151-154.
2莫丽慧,钟丽花.孟鲁司特联合布地奈德治疗支气管哮喘患儿的临床观察.中国药房,2017,28:1981-1984.
3于庆丰,季小玲,张宪涛.孟鲁司特联合布地奈德雾化吸入对支气管哮喘患者肺功能及血清嗜酸粒细胞阳离子蛋白、转化生长因子-β1水平的影响.实用心脑肺血管病杂志,2018,26:142-144.
4 Vijayakumar J,Subramanian S,Singh P,et al.Arterial inflammation in bronchial asthma.J Nucl Cardiol,2013,20:385-395.
5欧婧岚,汤华.布地奈德雾化吸入联合孟鲁司特钠对支气管哮喘患儿肺功能及CysLTs、FLAPmRNA表达的影响.现代医学,2017,45:1127-1130.
6刘传合,陈育智.儿童哮喘流行病学及防治现状分析.中国实用儿科杂志,2013,28:809-811.
7中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版).中华儿科杂志,2016,54:167-181.
8赵红丽.布地奈德联合孟鲁司特钠治疗支气管哮喘患儿的临床疗效和安全性.中国现代药物应用,2013,7:131-132.
9陈碧芬,王建雄,江铁成,等.儿童哮喘气道功能变化研究.中国临床医师杂志,2016,44:89-91.
10张佳佳,胡赤军,周小勤,等.布地奈德联合孟鲁司特钠对支气管哮喘患儿细胞因子、免疫功能影响.现代生物医学进展,2017,17:550-553.
11白润娥,李奴旺,高建萍.布地奈德联合孟鲁司特钠对支气管哮喘患儿细胞因子免疫功能的影响.中国药物与临床,2018,18:1360-1362.
12 Boyce JA,Barrett NA.Cysteinyl leukotrienes:an innate system for epithelial control of airway smooth muscleproliferation.Am J Resp Crit Care,2015,191:496-497.
13李秀莲.布地奈德联合孟鲁司特钠对支气管哮喘患儿临床疗效的影响分析.大家健康(学术版),2016,10:12-13.
14郑贵浪,吴家兴.孟鲁司特治疗儿童支气管哮喘的临床疗效及肺功能和细胞因子变化研究.中国全科医学,2015,18:1387-1389.
15张子友,朱厚才,杨先文,等.孟鲁司特片联合布地奈德雾化吸入治疗对儿童支气管哮喘呼吸道功能及血清IL-17、TGF-β2水平的影响.湖南师范大学学报(医学版),2018,15:151-154.