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目的对于支气管哮喘急性发作患儿,联合给予孟鲁司特钠和沙美特罗替卡松进行治疗,评估其临床疗效及对免疫因子的影响。方法选择在2014年10月-2015年6月舟山市妇幼保健院诊治的急性发作期哮喘患儿118例,随机分为研究组和对照组,每组59例,对照组患儿在常规治疗基础上应用沙美特罗替卡松治疗,研究组在对照组基础上给予孟鲁司特钠治疗。评估患儿治疗后日间和夜间哮喘症状、临床症状(或体征)消失时间结果、检测患儿治疗前后血液T淋巴细胞亚群结果。结果研究组患儿治疗后日间和夜间哮喘症状评分分别为(0.72±0.41)分和(0.92±0.41)分,对照组为(0.72±0.41)分和(0.92±0.41)分,两组比较,差异有统计学意义(P<0.05)。研究组患者治疗后咳嗽消失、喘憋或气促缓解、哮鸣音及湿罗音消失时间分别为(5.36±1.14)d、(6.20±1.29)d、(5.03±0.69)d、(5.56±1.13)d和(5.12±0.77)d,对照组为(7.88±1.20)d、(8.76±1.31)d、(6.59±0.74)d和(8.64±1.17)d,两组比较,差异有统计学意义(P<0.05)。研究组患儿治疗后CD4+和CD4+/CD8+分别为(42.95±7.30)%和(1.77±0.52)%,对照组为(39.06±8.26)%和(1.51±0.47),两组比较,差异具有统计学意义(P<0.05);研究组患儿治疗后CD8+为(22.95±4.38)%,对照组为(27.62±4.06)%,两组比较,差异具有统计学意义(P<0.05)。结论联合应用孟鲁司特钠和沙美特罗替卡松治疗支气管哮喘急性发作患儿,能够显著改善患儿临床症状或体征,且好转时间显著缩短,患儿治疗后免疫细胞显著恢复,临床效果明显。
Objective To treat montelukast sodium and salmeterol-fluticasone in children with acute exacerbation of bronchial asthma and evaluate their clinical efficacy and influence on immune factors. Methods 118 children with asthma who were diagnosed and treated in Zhoushan MCH hospital from October 2014 to June 2015 were randomly divided into study group and control group, with 59 cases in each group. The control group received routine treatment On the application of salmeterol and fluticasone treatment, the study group in the control group on the basis of montelukast sodium treatment. The results of asthma symptoms, clinical symptoms (or signs) disappearing time, daytime and nighttime after treatment in children were evaluated. Blood T lymphocyte subsets were detected before and after treatment. Results The scores of asthma symptoms in the study group were (0.72 ± 0.41) and (0.92 ± 0.41) days after treatment and (0.72 ± 0.41) and (0.92 ± 0.41) points respectively in the control group , The difference was statistically significant (P <0.05). The cough disappeared, wheezing or shortness of breath was relieved in the study group, the disappearance time of wheeze and wet rales were (5.36 ± 1.14) d, (6.20 ± 1.29) d, (5.03 ± 0.69) d, (5.56 ± 1.13) d and (5.12 ± 0.77) d respectively, and the control group was (7.88 ± 1.20) d, (8.76 ± 1.31) d, (6.59 ± 0.74) d and (8.64 ± 1.17) d respectively Significance (P <0.05). The percentage of CD4 + and CD4 + / CD8 + in the study group after treatment was (42.95 ± 7.30)% and (1.77 ± 0.52)% respectively, and in the control group was (39.06 ± 8.26)% and (1.51 ± 0.47) (P <0.05). The CD8 + in the study group was (22.95 ± 4.38)% after treatment and (27.62 ± 4.06)% in the control group. There was significant difference between the two groups (P <0.05). Conclusion The combination of montelukast sodium and salmeterol / fluticasone in children with acute asthma attack can significantly improve the clinical symptoms or signs in children and the improvement time was significantly shortened, children with immune cells significantly recovered after treatment, the clinical effect obvious.