[1]王晟,陈乐.咳嗽变异性哮喘患儿布地奈德吸入剂与孟鲁斯特钠联合治疗对血清IL-6,TNF-α,TGF-β和IgE水平影响及作用机制研究[J].现代检验医学杂志,2019,34(01):137-141.[doi:10.3969/j.issn.1671-7414.2019.01.036]
WANG Sheng,CHEN Le.Effects of Budesonide Inhalation Combined
with Montelukast Sodium on Serum IL-6，TNF-α，TGF-β1 and IgE Levels
in Children with Cough Variant Asthma and Its Mechanism[J].Journal of Modern Laboratory Medicine,2019,34(01):137-141.[doi:10.3969/j.issn.1671-7414.2019.01.036]
点击复制
咳嗽变异性哮喘患儿布地奈德吸入剂与孟鲁斯特钠联合治疗对血清IL-6,TNF-α,TGF-β和IgE水平影响及作用机制研究(
)
《现代检验医学杂志》[ISSN:/CN:]
- 卷:
-
第34卷
- 期数:
-
2019年01期
- 页码:
-
137-141
- 栏目:
-
检验与临床
- 出版日期:
-
2019-02-28
文章信息/Info
- Title:
-
Effects of Budesonide Inhalation Combined
with Montelukast Sodium on Serum IL-6，TNF-α，TGF-β1 and IgE Levels
in Children with Cough Variant Asthma and Its Mechanism
- 文章编号:
-
1671-
7414(2019)01-137-05
- 作者:
-
王晟1; 陈乐2
-
(1.上海市宝山区罗店医院
儿科，上海201908；
2.上海儿童医学中心急诊科，上海200127)
- Author(s):
-
WANG Sheng1; CHEN Le2
-
(1.Department
of Pediatrics，Luodian Hospital of Shanghai Baoshan District，Shanghai 20
1908，China；
2.Department of Emergency，Shanghai Children’s Medical Center，Shanghai
200127，China)
-
- 关键词:
-
孟鲁斯特钠; 咳嗽变异性哮喘; 炎症细胞因子; 转化生长因子
-β1; 免疫球蛋白E
- 分类号:
-
R562.25；R392.11
- DOI:
-
10.3969/j.issn.1671-7414.2019.01.036
- 文献标志码:
-
A
- 摘要:
-
目的研究布地奈德吸入剂与孟鲁斯特钠联合治疗方案对咳嗽变异性哮喘患儿白介素-6(I
L-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)和免疫球蛋白E(IgE)
水平影响及作用机制。方法选取2017年4月～2018年8月上海市宝山
区罗店医院咳嗽变异性哮喘婴幼儿116例，采用单双号法，分为研究组和对照组，每组58例
。对照组婴幼儿采用糖皮质激素类药物，如布地奈德粉吸入剂；观察组采用布地奈德粉吸入
剂联合孟鲁司特钠咀嚼片；观察两组婴幼儿治疗前(T0)、治疗2周(T1)、4周(T2)和8周(T3)
时咳嗽症状评分和IL-6，TNF-α，TGF-β1和IgE水平变化及咳嗽开始缓解、完全缓解时
间。结果T1，T2和T3每个时刻，研究组日间症状及夜间症状评分均
低于对照组，差异均有统计学意义( t=5.109~7.649，均P <0.05)。且T0，T1，T2，T3
时，两组婴幼儿日间症状评分、夜间症状评分均呈现下降趋势，与同组间比较，差异有统计
学意义( F=4.204~6.610，均P <0.05)。研究组咳嗽症状开始缓解时间及完全缓解时间
均少于对照组，差异有统计学意义( t=5.906，4.885，均P <0.05)。T1，T2和T3每个
时刻，研究组IL-6，TNF-α，TGF-β1和IgE水平均低于对照组，差异均有统计学意义(
t IL-6=3.953~4.204， t TNF-α=3.911~4.825， t TGF-β
1=4.140~4.300， t IgE=5.103~5，870，均 P <0.05)。且T0，T1，T2，T
3时，两组婴幼儿IL-6，TNF-α，TGF-β1和IgE水平均呈现下降趋势，与同组间比较，差
异有统计学意义( F=3，901~6.175，均P <0.05)。结论布地奈
德吸入剂与孟鲁斯特钠联合治疗方案通过降低咳嗽变异性哮喘婴幼儿炎症细胞因子，TGF-
β1，IgE水平能有效减轻气道炎症反应，治疗效果确切，为临床规范化治疗提供了一种新
路径，值得扩大样本深入研究。
- Abstract:
-
Objective To study the combination of budesonid
e inhaler and montelukast sodium in interleukin-6 (IL-6)，tumor necrosis fact
or-α (TNF-α) and transforming growth factor-β1 (TGF-β1) in children with
cough variant asthma．The influence of β1)，immunoglobulin E (IgE) levels and
mechanism of action．Methods A total of 116 infants with
cough variant asthma from April 2017 to August 2018 were enrolled in Luodian Hos
pital of Shanghai Baoshan District in Shanghai．The study was divided into study
g
roup and control group，with 58 cases in each group．In the control group，gluco
corticoids (such as budesonide powder inhaler) were used．The observation group
was treated with budesonide powder inhalation combined with montelukast sodium c
hewable tablets．The two groups of infants were treated before treatment (T0)，t
reatment cough symptom scores and changes in inflammatory cytokines，TGF-β1，I
gE levels，and cough start remission and complete remission time at 2 weeks (T1)
，4 weeks (T2) and 8 weeks (T3)．Results At each time of
T1，T2 and T3，the daytime symptoms and nocturnal symptoms scores of the study g
roup were lower than the control group and the differences were statistically si
gnificant ( t =5.109~7，649，all P <0.05)．At the time of T0，T1，T2 and
T3，the daytime symptom scores and nocturnal symptom scores of the infants in b
oth groups showed a downward trend．Compared with the same group，the difference
was statistically significant ( F =4.204~6，610，all P <0.05)．The time
to complete the remission of the cough symptoms and the time of complete remiss
ion were lower in the study group than in the control group，and the difference
was statistically significant ( t =5.906~4.885，all P <0.05)．At each ti
me of T1，T2 and T3，the levels of IL-6，TNF-α，TGF-β1 and IgE in the study
group were lower than those in the control group，and the differences were stat
istically significant ( t IL-6=3.953~4.204， t TNF-α=3.911
~4.825， t TGF-β1=4.140~4.300， t IgE=5.103~5，870，均 P
<0.05)．At the time of T0，T1，T2 and T3，the levels of IL-6，TNF-a，TGF-
β1 and IgE in the two groups showed a downward trend．Compared with the same gr
oup，the difference was statistically significant ( F =3.901~6.175，all P
<0.05)．Conclusion The combination of montelustner reg
imen can effectively reduce airway inflammation by reducing the levels of inflam
matory cytokines，TGF-β1 and IgE in infants with cough variant asthma．The the
rapeutic effect is clear and provides a new path for clinical standardized treat
ment．It is worth expanding the sample to conduct in-depth research．
参考文献/References:
[1］郭建光．孟鲁司特联合布地奈德福莫特罗治疗小儿咳嗽变异性哮喘的疗效
及对患儿免疫功能指标的影响［J］．中国妇幼保健，2018，33(17)：3917-3919．
GUO Jianguang.Montelukast combined with budesonide formoterol in
the treatment of children with cough variant asthma and its effect on immune fun
ction indicators in children［J］．Maternal and Child Health Care of China，2018
，33 (17)：3917-3919．
[2］MURPHY K R，DHAND R，TRUDO F，et al．Therapeutic equivalence of budesoni
de/formoterol delivered via breathactuated inhaler vs Pmdi［J］．Respir Med，201
5，109(2)：170-179．
[3］韦艳征，张潇潇，朱贤桂．孟鲁司特钠联合布地奈德混悬液对小儿咳嗽变异性哮喘
的疗效观察［J］．中国医药指南，2018，16(13)：92-93．
WEI Yanzheng，ZHANG Xiaoxiao，ZHU Xiangui．Efficacy of montelukast s
odium combined with budesonide suspension in children with cough variant asthma
［J］．Guide of China Medicine，2018，16(13)：92-93．
[4］KANEMITSU Y，NIMI A，MATSUMOTO H，et al．Gastroesophageal dysmotility is
associated with the impairment of cough-specific quality of life in patients wi
th cough variant asthma［J］．Allerg Int，2016，65(3)：320-326．
[5］吴莉菁，肖国军．孟鲁司特钠片联合布地奈德混悬液治疗咳嗽变异性哮喘患儿的临
床研究［J］．中国临床药理学杂志，2016，32(22)：2032-2034，2038．
WU Lijing，XIAO Guojun．Clinical trial of montelu-kast combined wit
h budesonide in the treatment of children with cough variantion asthma［J］．Chi
nese Journal of Clinical Pharmacology，2016，32(22)：2032-2034，2038．
[6］郝伟迤．布地奈德/福莫特罗治疗咳嗽变异性哮喘的临床效果及对血清IL-4，TNF-
α 的影响［J］．解放军医药杂志，2018，30(6)：79-82．
HAO Weiyi．Clinical effecacy of budesonide/formoterol in treatment
of patients with cough variant asthma and its effect on serum IL-4 and TNF-α
［J］．Medical Journal of Chinese People’s Liberation Army，2018，30(6)：79-82
．
[7］张迎霞．孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘疗效观察［J］．中国中
西医结合儿科学，2017，9(5)：430-432．
ZHANG Yingxia．Clinical effect of montelukast sodium and budesonide
in children with cough variant asthma［J］．Chinese Pediatrics of Integrated Tra
ditional and Medicine，2017，9(5)：430-432．
[8］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)［J］．中华儿科杂志，2016，54(3)：167-181．
Department of Respiratory Medicine，Pediatrics Bra-nch，Chinese Med
i
cal Association，Editorial Board of “Chinese Journal of Pediatrics”．Guideline
s for Diagnosis and Prevention of Bronchial Asthma in Children (2016 Edition)［J
］．Chinese Journal of Pediatrics，2016，54(3)：167-181．
[9］李明安，司丽媛，吴红波，等．哮喘患儿外周血单个核细胞瘦素及Foxp3的表达［J
］．现代检验医学杂志，2016，31(4)：58-61，64．
LI Mingan，SI Liyuan，WU Hongbo，et al．Expression of leptin and Fox
p3 in peripheral blood mononuclear cells of children with bronchial asthma［J］
．Journal of Modern Laboratory Medicine，2016，31(4)：58-61，64．
[10］吴海丽，李贤斌．气雾型布地奈德联合孟鲁司特钠治疗小儿咳嗽变异性哮
喘疗效及对肺功能和血清炎症因子的影响［J］．海南医学院学报，2016，22(5)：467-469
，473．
WU Haili，LI Xianbin．Efficacy of aerosol budesoni-de combined with monte
lukast in treatment of children with cough variant asthma and its influence on l
ung function and serum inflammatory factor［J］．Journal of Hainan Medical Colle
ge，2016，22(5)：467-469，473．
[11］BARBOSA J S，ALMEIDA PAZ F A，BRAGA S S．Montelukast medicines of today
and tomorrow： from molecular pharmaceutics to technological formulations［J］．
Drug Deliv，2016，23(9)：3257-3265．
[12］许银姬，周明娟，梁桂兴，等．咳嗽变异性哮喘患者规范治疗2年的随访研究［J］
．广东医学，2016，37(14)：2104-2107．
XU Yinji，ZHOU Mingjuan，LIANG Guixing，et al．Standard treatment for coug
h variant asthma：A clinical trail of two years follow-up［J］．Guangdong Medic
al Journal，2016，37(14)：2104-2107．
[13］徐翼，盛泽波．孟鲁斯特钠、沙美特罗替卡松联合小剂量氨茶碱对成人咳嗽变异性
哮喘患者血清TNF-α，TGF-β1和IgE水平的影响［J］．海南医学，2017，28(20)：3272
-3275．
XU Yi，SHENG Zebo．Effects of montelukast sodium and salmeterol in combina
tion with low-dose aminophylline on serum levels of TNF-α，TGF-β1 and IgE i
n patients with adults cough variant asthma［J］．Hainan Medical Journal，2017，
28(20)：3272-3275．
[14］汤建梅．孟鲁司特钠联合布地奈德对咳嗽变异性哮喘患儿血清免疫球蛋白E、白细
胞介素-4及转化生长因子-β1水平的影响［J］．吉林医学，2017，38(3)：520-521．
TANG Jianmei．Effects of montelukast sodium combined with budesonide on se
rum immunoglobulin E，interleukin-4 and transforming growth factor-β1 levels
in children with cough variant asthma［J］．Jilin Medical Journal，2017，38(3)：
520-521．
[15］雷旭艳．儿童咳嗽变异性哮喘过敏原及血清IgE定量检测研究［J］．现代诊断与治
疗，2018，29(15)：2472-2474．
LEI Xuyan．Quantitative detection of allergens and serum IgE in children w
ith cough variant asthma［J］．Modern Diagnosis and Treatment，2018，29(15)：247
2-2474．
[16］魏延，李东升，刘建军，等．孟鲁司特钠联合布地奈德治疗儿童咳嗽变异性哮喘疗
效和安全性的Meta分析［J］．中国当代儿科杂志，2016，18(11)：1100-1105．
WEI Yan，LI Dongsheng，LIU Jianjun，et al．Therapeutic effect and safety o
f montelukast sodium combined with budesonide in children with cough variant ast
hma：A meta analysis［J］．Chinese Journal of Contemporary Pediatrics，2016，18(
11)：1100-1105．
[7］HUANG Jianping，JOCHEMS C，TALAIE T，et al．Elevated serum soluble CD40 ligand in cancer patients may play an immunosuppressive role［J］．Blood，2012，1
20(15)：3030-3038．
[8］LIN R J，AFSHAR-KHARGHAN V，SCHAFER A I．Paraneoplastic thrombocytosis：the secrets of tumor self-promotion［J］．Blood，2014，124(2)：184-187．
[9］郑冬菊，房磊，姬艳菊，等．平均血小板体积与早期胃癌相关性研究［J］．吉林医
学，2016，37(9)：2178-2180．
ZHENG Dongju，FANG Lei，JI Yanju，et al．Association of mean plate
let volume with early gastric cancer［J］．Jilin Medical Journal，2016，37(9)：2
178-2180．
[10］KUMARI N，DWARAKANATH B S，DAS A，et al．Role of interleukin-6
in cancer progression and therapeutic resistance［J］．Tumour Biol，2016，37(9)
：11553-11572．
[11］KOWANETZ M，WU X，LEE J，et al．Granulocyte-colony stimulating factor p
romotes lung metastasis through mobilization of Ly6G+Ly6C+ granulocytes［J］．Pr
oc Natl Acad Sci USA，2010，107(50)：21248-21255．
[12］HUANG Weili，LI Yangguang，L Yongchen，et al．Use of lectin mic
roarray to differentiate gastric cancer from gastric ulcer［J］．World J Gastroe
nterol，2014，20(18)：5474-5482．
[13］成龙，李志国，李森，等．胃癌患者血小板计数与其临床病理因素的关系［J］．
哈尔滨医科大学学报，2016， 50(3)：267-270．
CHENG Long，LI Zhiguo，LI Sen，et al．Association of platelet count and cl
inicopathological factors in gastric cancer［J］．Journal of Harbin Medical Univ
ersity，2016，50(3)：267-270．
备注/Memo
- 备注/Memo:
-
作者简介：王晟(1976-)，男，大学本科，主治医师，研究方向：儿科疾病的诊治研究，E-mail： drw
1990@126.com。
更新日期/Last Update:
2019-02-28