孟鲁司特联合舒利迭治疗哮喘的临床疗效及对Th17、Treg细胞平衡和IL－4、IFN－γ表达的影响

摘要

Objective To evaluate the effect of montelukast combined with seretide in treatment of patients with asthma and its influence on balance between Th17 and Treg cells, and expression of IL-4 and IFN-γ.Methods 110 patients with asthma were randomly divided into observation group and control group, observation group of 55 cases, using montelukast combined with seretide, control group of 55 cases, using seretide,compared two groups of patients with pulmonary function changes, peripheral inflammatory factor changes and influence on Th17 and Treg cells balance. Results Before treatment, observation group and control group,FEV1 and FEV1 /FVC value was no significant difference.FEV1 and FEV1 /FVC after treatment were significantly improved compared with before treatment in two groups, differences were statistically significance (P<0.05).Between two groups, FEV1 values were significantly difference (t=8.1156, P=0.0001), FEV1 /FVC also had significant difference (t=4.8933, P=0.0001) .Before treatment, observation group and control group, IL-4 and IFN-γdid not have a statistically significant.After treatment, IL-4 and IFN-γdecreased significantly, with statistical difference compared with before treatment (P<0.05).Between two groups, IL-4 had significant difference (t=6.0273, P=0.0001), IFN-γalso had statistically significant (t=6.6042, P=0.0001).Before treatment, there was no significant difference between Th17 and Treg percentage, after 12 weeks of treatment and 24 weeks, Th17 in observation group were(0.53 ±0.02),(0.32 ±0.01), the control group were (0.78 ±0.03),(0.62 ±0.02), which had differences (P<0.05).After 12 weeks and 24 weeks,observation group Treg respectively(2.21 ± 0.22),(2.47 ±0.10),in control group were(1.50 ±0.11),(1.84 ±0.14), Treg percentage at different time after treatment, the differences had statistically significant (P<0.05).Conclusion Montelukast combined with Seretide in treating with asthma, pulmonary function of patients is obviously improved, and it can improve Th17, Treg cell.%目的：评价孟鲁司特联合舒利迭治疗哮喘的临床疗效及对Th17、Treg细胞平衡和IL－4，IFN－γ表达的影响。方法选取2011年5月～2013年4月郑州大学附属郑州中心医院收治的哮喘患者共计110例，按照随机数字表法分为观察组和对照组，其中观察组55例，采用孟鲁司特联合舒利迭治疗，对照组55例，采用单用舒利迭治疗，观察并比较2组患者的临床疗效、肺功能变化情况、外周血炎症因子变化情况及Th17与Treg细胞平衡的转归。结果治疗前观察组和对照组FEV1及FEV1／FVC值相比差异无统计学意义，治疗后2组FEV1与FEV1／FVC的值均得到明显改善，相比治疗前差异均具有统计学意义（ P＜0．05）。组间比较，2组FEV1值相比差异有统计学意义（t＝8．1156， P＝0．0001），FEV1／FVC值相比差异具有统计学意义（t＝4．8933，P＝0．0001）；治疗前观察组和对照组IL－4及IFN－γ值相比，差异不具有统计学意义，治疗后2组IL－4及IFN－γ均明显下降，与同组治疗前相比差异具有统计学意义（P＜0．05）。组间比较，观察组IL－4值与对照组相比，差异具有统计学意义（t＝6．0273，P＝0．0001），IFN－γ的值与对照组相比差异具有统计学意义（ t＝6．6042，P＝0．0001）；治疗前2组Th17及Treg百分比，差异无统计学意义，治疗后12周及24周，观察组Th17的值分别为（0．53±0．02）、（0．32±0．01），对照组分别为（0．78±0．03）、（0．62±0．02），不同时段Th17所占百分比相比差异均具有统计学意义（ P＜0．05）。治疗后12周及24周，观察组Treg值分别为（2．21±0．22）、（2．47±0．10），对照组分别为（1．50±0．11）、（1．84±0．14），不同时段Treg百分比相比差异均具有统计学意义（P＜0．05）。结论孟鲁司特联合舒利迭治疗哮喘疗效好，患者肺功能改善明显，且可明显改善Th17、Treg细胞平衡。