白三烯受体拮抗剂对呼吸道合胞病毒性毛细支气管炎Thl／Th2细胞平衡的影响

摘要

目的：探讨白三烯受体拮抗剂对呼吸道合胞病毒（RSV）性毛细支气管炎气道炎症的作用及对毛细支气管炎后发生哮喘倾向的预防作用。方法：将186例RSV毛细支气管炎住院患儿随机分成A组（n＝69）、B组（n＝65）和C组（n＝52），分别应用孟鲁司特钠口服、布地奈德混悬液氧喷3月、不作处理，比较三组住院当日、干预前、干预后γ－干扰素（γ－IFN ）、白介素－12（ IL－12）、白介素－13（ IL－13）及白三烯 E4（ LTE4）的变化。结果： RSV毛细支气管炎患儿IL－13及LTE4水平在急性期、恢复期明显升高，而IL－12及γ－IFN水平降低；A组及B组患儿干预结束后IL－13、LTE4水平均较干预前明显下降，IL－12、γ－IFN水平上升；A组喘息再次发作率明显减少。结论：白三烯受体拮抗剂能调节Thl／Th2的失衡，减少LTE4的释放，减轻气道炎症和气道高反应性，对RSV 性毛细支气管炎后发生哮喘倾向有积极的预防作用。%Objective:To explore the effect of leukotriene receptor antagonist on the airway inflammation of respiratory syncytial virus (RSV) bronchiolitis and the tendency of preventing capillary bronchitis asthma. Methods:186 hospitalized children with RSV capillary bronchitis were randomly divided into group A (n=69), group B (n=65) and group C(n=52) accepted singulair,budesonide suspension liquid oxygen injection and nothing treatment respectively for 3 month. The level of γ-IFN、 IL-12、 IL-13 and LTE4 were compared on the in-hospital day,before and after the intervention among the three group. Results: The levels of IL-13 and LTE4 in acute stage and recovery increased significantly in children with RSV capillary bronchitis, while IL-12 and γ- IFN decreased. Compared with before the treatment,the levels of IL-13, LTE4 in group A and group B decreased after the treatment, while the IL- 12, γ-IFN levels increased. The again attack rate of asthma in group A obviously reduced. Conclusion:Leukotriene receptor antagonists can reduce airway inflammation and high reactivity by adjusting the imbalance of Thl/Th2 and have a positive role in prevention for RSV after capillary bronchitis asthma tendency.