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目的:观察孟鲁司特钠对小儿毛细支气管炎Th17/Treg的调节作用及疗效。方法:选取2013年6月至2015年4月我院儿科治疗的毛细支气管炎患儿124例,随机分为对照组和观察组各62例。对照组给予常规综合治疗,包括吸氧、利巴韦林抗病毒、沙丁胺醇气雾剂平喘、合并细菌感染时抗感染、氯丙嗪镇静等;观察组在对照组治疗基础上加用孟鲁司特钠片4 mg/d,每天睡前顿服,连续治疗7 d。流式细胞仪检测Th17和Treg细胞水平,ELISA法测定IL-17和IL-10表达水平,评价疗效。结果:治疗前,两组Th17、Treg、IL-17、IL-10水平比较差异无统计学意义(P均>0.05);治疗后,两组Th17、IL-17水平均降低且观察组低于对照组,Treg、IL-10水平均升高且观察组高于对照组(P均<0.05)。观察组总有效率为90.32%,高于对照组的72.58%,且症状消失时间和住院时间均短于对照组(P均<0.05)。结论:孟鲁司特钠可以调节毛细支气管炎患儿体内Th17/Treg平衡,对小儿毛细支气管炎具有一定的临床应用价值。
Objective: To observe the regulatory effect and efficacy of montelukast sodium on Th17 / Treg in children with bronchiolitis. Methods: A total of 124 children with bronchiolitis treated in our hospital from June 2013 to April 2015 were randomly divided into control group and observation group with 62 cases each. The control group were given conventional comprehensive treatment including oxygen inhalation, ribavirin antiviral, albuterol aerosol anti-asthma, anti-infection with bacterial infection, sedation of chlorpromazine and so on; the observation group was added on the basis of the control group Stratton 4 mg / d, Dayton bed before going to bed, continuous treatment of 7 d. The levels of Th17 and Treg cells were detected by flow cytometry. The expressions of IL-17 and IL-10 were detected by ELISA. The curative effect was evaluated. Results: Before treatment, the levels of Th17, Treg, IL-17 and IL-10 in the two groups had no significant difference (all P> 0.05). After treatment, the levels of Th17 and IL-17 in both groups decreased and the levels in the observation group were lower than The levels of Treg and IL-10 in control group were higher than those in control group (P <0.05). The total effective rate in the observation group was 90.32%, which was higher than that in the control group (72.58%), and the disappearance time and hospitalization time were shorter in the observation group than those in the control group (all P <0.05). Conclusion: Montelukast sodium can regulate the balance of Th17 / Treg in children with bronchiolitis, and has certain clinical value for children with bronchiolitis.