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目的:探讨孟鲁司特治疗儿童过敏性紫癜的疗效及对血清细胞因子的影响。方法:选取70例过敏性紫癜患儿,随机分为实验组和对照组各35例。两组患儿均给予常规治疗,包括葡萄糖酸钙、维生素、抗组胺药、糖皮质激素、抗生素等。实验组在此基础上加用孟鲁司特每日1次口服,<6岁每次2.5 mg,≥6岁每次5 mg,疗程4周。观察两组患儿治疗前后的血清细胞因子IL-6、IL-12水平的变化,同时评价两组患儿的治疗效果并观察不良反应。结果:治疗4周后,两组患儿血清细胞因子IL-6、IL-12水平较治疗前明显下降(P<0.05),且实验组下降幅度明显优于对照组(P<0.05)。治疗4周后,实验组总有效率97.1%,明显优于对照组的77.1%(χ2=4.59,P<0.05)。两组患儿服药后均出现1例胃肠道症状,经过对症治疗后好转。结论:孟鲁司特治疗儿童过敏性紫癜能够减少促炎因子的表达,治疗效果佳,不良反应少,是一种安全有效的药物。
Objective: To investigate the therapeutic effect of montelukast on children with Henoch-Schonlein purpura and its effect on serum cytokines. Methods: Seventy children with Henoch-Schonlein purpura were randomly divided into experimental group and control group (n = 35). Two groups of children were given conventional treatment, including calcium gluconate, vitamins, antihistamines, glucocorticoids, antibiotics and so on. The experimental group on this basis plus montelukast daily oral, <6-year-old 2.5 mg each, ≥ 6-year-old 5 mg each for 4 weeks. The changes of serum cytokines IL-6 and IL-12 levels before and after treatment in both groups were observed. At the same time, the therapeutic effects of both groups were evaluated and adverse reactions were observed. Results: After 4 weeks of treatment, serum cytokines IL-6 and IL-12 in both groups were significantly lower than those before treatment (P <0.05), and the decreasing rate in the experimental group was significantly better than that in the control group (P <0.05). After 4 weeks of treatment, the total effective rate in the experimental group was 97.1%, which was significantly better than that in the control group (χ2 = 4.59, P <0.05). After taking two groups of children with gastrointestinal symptoms occurred in 1 case, after symptomatic treatment improved. Conclusion: Montelukast treatment of children with Henoch-Schonlein purpura can reduce the expression of proinflammatory cytokines, with good curative effect and few adverse reactions. It is a safe and effective drug.