目的：探讨孟鲁司特治疗儿童支气管哮喘的临床疗效及其与肺功能、核因子（ NF）-κB、白介素（IL）-6、IL -8水平的关系。方法选取2012年7月—2013年7月广东医学院附属医院儿童医学中心就诊的8~14岁支气管哮喘患儿82例，采用随机数字表法分为对照组40例，治疗组42例。两组患儿均给予布地奈德雾化、辅以化痰止咳治疗，喘息加重时加以β-受体激动药雾化，有细菌感染时加用抗菌药物；治疗组在此基础上，加用孟鲁司特钠咀嚼片5 mg/ d，连续服药12周。观察两组患儿临床疗效，检测肺功能，酶联免疫吸附测定法（ ELISA）检测NF -κB、IL -6、IL -8水平。结果治疗后，对照组支气管哮喘未控制10例、部分控制10例、控制20例，治疗组未控制4例、部分控制5例、控制33例，两组临床疗效比较，差异有统计学意义（u ＝-2.680，P ＝0.007）。治疗前，两组患儿第1秒用力呼气末容积（FEV1）、用力呼气流量（PEF）、NF -κB、IL -6、IL -8水平比较，差异均无统计学意义（P ＞0.05）；治疗后，治疗组患儿 FEV1、PEF 较对照组升高（P ＜0.05），治疗组患儿 NF -κB、IL -6、IL -8水平较对照组降低（P ＜0.05）。结论孟鲁司特明显改善支气管哮喘患儿症状与体征，提高肺功能，同时可以降低NF -κB、IL -6、IL -8水平。%Objective To evaluate the clinical efficacy of montelukast on childhood asthma,and its relationship with lung function,NF - κB,IL - 6 and IL - 8. Methods A total of 82 8 - 14 years old patients with childhood asthma who were treated in Department of Pediatrics in Affiliated Hospital of Guangdong Medical College from July 2012 to July 2013,were divided into control group(40 cases)and treatment group(42 cases)by using random number table method. All case in both groups were given atomization inhalation of budesonide,relieving cough and reducing sputum treatment,atomization inhalation of βreceptor agonists during asthma exacerbation,and antibacterial drugs if infection existed;cases in treatment group were given montelukast sodium chewable tablets 5 mg/ d for 12 weeks. The clinical efficacy was observed,lung function was detected,and ELISA was used to detect levels of NF - κB,IL - 6 and IL - 8. Results After treatment,no control 10 cases,part of control 10 cases,control 20 cases in control group;no control 4 cases,part of control 5 cases,control 33 cases in treatment group. There was significant difference in clinical efficacy between the two groups(u = - 2. 680,P = 0. 007). Before treatment,there was no significant difference in FEV1 ,PEF,levels of NF - κB,IL - 6 and IL - 8 between the two groups of cases(P > 0. 05). After treatment,FEV1 and PEF of cases in treatment group was significantly higher than those of cases in control group(P <0. 05),respectively,and the levels of NF - κB,IL - 6 and IL - 8 in treatment group were significantly lower than those in control group(P < 0. 05). Conclusion Montelukast can significantly improve children's asthma symptoms and signs,improve lung function,and reduce levels of NF - κB,IL - 6 and IL - 8.
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