标题：孟鲁司特钠治疗儿童咳嗽变异型哮喘的疗效及其对患者血清免疫球蛋白E、白介素-4的影响

      作者：林秀玲，刘和平
    （佛山市顺德区大良医院儿科，广东 佛山 528300)

      卷次： 2016年27卷13期

      【摘要】 目的 探讨孟鲁司特钠对儿童咳嗽变异型哮喘(CVA)的临床疗效及其对患儿血清免疫球蛋白 E
（IgE）以及白介素-4（IL-4）的影响。方法 将2013年1月至2015年2月我院儿科收治的98例CVA患儿以数表法
随机分为观察组(n=49)与对照组(n=49)，对照组给予布地奈德气雾剂治疗，观察组在对照组基础上加用孟鲁司特钠
治疗，比较两组患儿的临床疗效，以及治疗前后患儿血清 IgE及 IL-4水平的变化情况。结果 观察组患儿的治疗
总有效率为95.9%（47/49），显著高于对照组的67.3%(33/49)，差异有显著统计学意义(P<0.01)；观察组患儿的咳嗽缓解
时间和咳嗽消失时间分别为(3.82±1.11) d和(6.46±1.38) d，均显著短于对照组的(6.02±1.14) d和(10.23±1.50) d，差异均
有显著统计学意义(P<0.01)；治疗后观察组 IgE为(148.2±43.5) KU/L，IL-4为(67.6±11.7) ng/mL，均显著低于治疗前的
(277.4±44.2) KU/L与(90.4±12.2) ng/mL，对照组治疗后IgE为(168.3±42.9) KU/L，IL-4为(75.4±12.1) ng/mL，均显著低
于治疗前的(278.3±43.6) KU/L与(91.0±12.4) ng/mL，且治疗后观察组的 IgE及 IL-4水平均明显低于对照组，差异均
有统计学意义(P<0.05)。结论 孟鲁司特钠用于CVA患儿的治疗能够有效降低 IgE、IL-4水平，抑制Ⅰ型变态反
应，从而更加快速的缓解患儿临床症状，疗效确切，安全可靠，值得推广应用。

      【关键词】 孟鲁司特钠；咳嗽变异型哮喘；血清免疫球蛋白E；白介素-4

      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2124—03


Clinical effects of montelukast in the treatment of cough variant asthma (CVA) and its influence on serum IgE
and IL-4.
LIN Xiu-ling, LIU He-ping. Department of Pediatrics, Daliang Hospital of Shunde District of Foshan City,
Foshan 528300, Guangdong, CHINA

【Abstract】 Objective To discuss the clinical effect of montelukast in the treatment of effect cough variant asthma
(CVA) and its influence on serum immunoglobulin E (IgE) and interleukin-4 (IL-4). Methods A total of 98 children with
CVA, who admitted to the Department of Pediatrics in our hospital from January 2013 to February 2015, were randomly di-
vided into the observation group (n=49) and the control group (n=49) according to digital table. The control group was treat-
ed with budesonide aerosol, and the observation group were treated with budesonide aerosol and montelukast. Then the clin-
ical effects and level changes of IgE and IL-4 were contrasted between the two groups. Results The effective rate of the
observation group [95.9% (47/49)] was significantly higher than that of the control group [67.3% (33/49)] (P<0.01). The
time of cough relief and disappearance time in the observation group [(3.82±1.11) d, (6.46±1.38) d, respectively] were sig-
nificantly shorter than those in the control group [(6.02±1.14) d, (10.23±1.50) d, respectively] (P<0.01). In the observation,
the levels of IgE and IL-4 after the treatment [(148.2±43.5) KU/L, (67.6±11.7) ng/mL, respectively] were significantly lower
than before the treatment [(277.4±44.2) KU/L, (90.4±12.2) ng/mL, respectively] (P<0.01); In the control group, the levels of
IgE and IL-4 after the treatment [(168.3±42.9) KU/L, (75.4±12.1) ng/mL, respectively] were significantly lower than be-
fore the treatment [(278.3±43.6) KU/L, (91.0±12.4) ng/mL, respectively] (P<0.01), and the levels of IgE and IL-4 of the ob-
servation group were significantly lower than those of the control group (P<0.01). Conclusion Montelukast can effective-
ly reduce the level of IgE and IL-4, inhibit type Ⅰ allergic reaction, and more rapidly relieve the clinical symptoms.
Montelukast is effective, safe and reliable in the treatment of cough variant asthma, which is worth popularizing.

      【Key words】 Montelukast; Cough variant asthma (CVA); Immunoglobulin E (IgE); Interleukin-4 (IL-4)
·论 著·
6350.2016.13.021