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目的:探讨白三烯拮抗剂对轻、中度哮喘患儿情绪状态及Th1/Th2细胞因子的影响。方法:将108例哮喘患者随机分为3组,Ⅰ组:吸入普米克气雾剂200μg/次,2次/d;Ⅱ组:在吸入普米克气雾剂的基础上,口服白三烯拮抗剂扎鲁司特10mg,1次/d;Ⅲ组:口服扎鲁司特10mg,1次/d。疗程均为4周。治疗前后评定患儿焦虑、抑郁水平,并检测血清中γ-干扰素(IFN-γ)及白细胞介素4(L-4)的含量。结果:3组哮喘患儿治疗后焦虑及抑郁的评分均低于治疗前(P<0.01)。治疗后II组患儿焦虑及抑郁的评分低于Ⅰ组和Ⅲ组(P<0.01);经治疗后3组哮喘患儿血清中的IFN-γ升高而L-4降低,治疗后II组的IFN-γ高于Ⅰ组和Ⅲ组、L-4低于Ⅰ组和Ⅲ组,而Ⅰ组和Ⅲ组之间无差异(P>0.05)。结论:扎鲁司特在改善哮喘患儿的焦虑及抑郁、调节Th1/Th2失衡方面的效果与吸入糖皮质激素相当,但与吸入糖皮质激素联合应用时,则有较明显的优势。
Objective: To investigate the effects of leukotriene antagonists on the emotional status and Th1 / Th2 cytokines in children with mild to moderate asthma. Methods: One hundred and eighty patients with asthma were randomly divided into three groups: Group Ⅰ: inhaled Pulmicort aerosol 200μg / time, twice a day; Group Ⅱ: On the basis of inhaled Pulmicort aerosol, oral leukotriene antagonism Agent zafirlukast 10mg, 1 time / d; group Ⅲ: oral zafirlukast 10mg, 1 time / d. The course of treatment is 4 weeks. The levels of anxiety and depression in children were evaluated before and after treatment. The contents of IFN-γ and IL-4 in serum were also measured. Results: The scores of anxiety and depression in three groups of children with asthma after treatment were lower than those before treatment (P <0.01). After treatment, the scores of anxiety and depression in Group II children were lower than those in Group I and III (P <0.01); The levels of IFN-γ in serum of the three groups were increased and L-4 decreased after treatment, and those in Group II IFN-γ in group Ⅰ and group Ⅲ were higher than those in group Ⅰ and group Ⅲ, while there was no difference between group Ⅰ and group Ⅲ (P> 0.05). Conclusion: Zafirlukast is effective in improving anxiety and depression in children with asthma, regulating imbalance of Th1 / Th2 and glucocorticoid inhalation, but has obvious advantages when used in combination with inhaled glucocorticoid.