目的：研究孟鲁司特治疗对支气管哮喘患者肺功能及Th1、Treg平衡的调节作用。方法40例儿童支气管哮喘患者随机均分为两组。研究组口服孟鲁司特片5 mg/d，对照组口服维生素B1（安慰剂）10 mg/d。收集外周血样，测定干扰素γ（IFN-γ）和白细胞介素4（IL-4）的水平。观察两组患者治疗前、治疗1个月、3个月、6个月肺功能指标[1 s用力呼气容积占预测值（ FEV1％ pred）、1 s用力呼气容积占用力肺活量比值（ FEV1/FVC）、1 s用力呼气容积（FEV1）]；检测两组治疗后胸膜厚度及胸膜滑动度。比较两组临床治疗效果。结果治疗后研究组患者血清IFN-γ、IL-4和IgE水平均明显高于对照组，差异具有统计学意义（ P ﹤0.05）。治疗后6个月研究组肺功能指标 FEV1％pred、FEV1/FVC和FEV1均优于对照组（ P ﹤0.05）。研究组治疗后胸膜厚度要厚于对照组，胸膜滑动度优于对照组，差异具有统计学意义（ P ﹤0.05）。研究组的疗效总有效率为90.0％，高于对照组的60.0％，差异具有统计学意义（ P﹤0.05）。结论孟鲁司特能有效改善哮喘患者的肺功能，并调节Th1/ Th17细胞平衡。%Objective To study the lung function and Th1/Treg balance regulation of Montelukast in treatment of patients with asthma. Methods 40 cases of hospitalized pediatric patients with bronchial asthma were randomly divided into two groups,the treatment group were trea-ted with montelukast tablets( Singulair),5 mg/d and the control group was treated with vitamin B1( placebo),10 mg/d. Peripheral blood sam-ples were collected to measure levels of IFN-γand IL-4 in. The indicators of lung function before treatment and 1,3 and 6 months later after treatment,and pleural thickness,pleura slide after treatment between 2 groups were observed and compared. The therapeutic effects of the two groups were compared. Results The level of IFN-γ,IL-4 and IgE in treatment group after treatment were significantly higher than those of control group( P ﹤0. 05). The lung function of treatment group was stronger than that of control group 6 months after treatment with statistical significant difference( P ﹤0. 05). Postoperative pleural thickness of study group was thicker than that of the control group,so was the pleura slide( P ﹤0. 05). The total effective rate of treatment group(90. 0%)was higher than that of control group(60. 0%)( P ﹤0. 05). Conclu-sion Montelukast can improve the lung function of asthma patients,and regulate the balance of Th1/ Th17 cells.
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