布地奈德联合孟鲁司特对儿童哮喘肺功能免疫功能及生长发育的影响

摘要

目的 探讨布地奈德联合孟鲁司特对儿童哮喘肺功能、免疫功能及生长发育的影响.方法 选择2014年1月至2015年12月本院儿科收治的支气管哮喘患儿80例,按照随机数字法分为观察组与对照组各40例.对照组规律口服孟鲁司特钠咀嚼片(5 mg/片),每晚睡前服用5 mg;观察组在对照组基础上联合吸入小剂量布地奈德鼻喷雾剂(100 μg/喷),早晚各使用1次.2组均连续使用1年,比较2组干预后第1秒用力呼气容积(FEV1),第1秒用力呼气量占用力肺活量比值(FEV1/FVC)、干预后2组免疫球蛋白M(IgM)、IgG及IgA水平、干预后CD4+和CD8+双阳性T细胞(DP)、CD4+/CD8+变化情况及干预后身高增长速度、体质量增长速度及骨矿物含量.结果 干预后观察组患者FEV1、FEV1/FVC水平高于干预后对照组,差异有统计学意义(P<0·05),干预后观察组 IgM、IgG及 IgA水平均显著高于对照组,差异有统计学意义(P<0·05),干预后观察组CD4+、CD8+水平,CD4+/CD8+比值大于对照组,差异有统计学意义(P<0·05),干预后观察组身高增长速度慢于对照组,差异有统计学意义(P<0·05),体质量增长速度慢于对照组,差异有统计学意义(P<0·05),骨矿物含量低于对照组(P<0·05).结论 哮喘患儿长时间吸入小剂量布地奈德能有效改善患儿肺功能,提高机体免疫能力,但对机体生长发育有一定影响,故临床使用应注意权衡利弊.%Objective To investigate the effects of budesonide combined with montelukast on pulmonary function,immune function and growth and development in children with asthma.Methods Eighty cases of chil-dren with bronchial asthma from January 2014 to December 2015 for pediatric treatment were selected.They were divided into two groups by random number method(observation group and control group),40 cases in each group.Control group had regular oral montelukast chewable tablets with 5 mg/tablet,taking 5 mg before bed ev-ery night.On the basis of the control group,the observation group received combined inhalation of a small dose of budesonide nasal spray with 100 μg/spray,1 time in the morning and 1 time in the night.Two groups were trea-ted for 1 year.After the intervention,FEV1(The first second to exhale volume),FEV1/FVC(the ratio of forced expiratory volume in the first second),IgM,IgG,IgA,DP(CD4+and CD8+double positive cells)、CD4+/CD8+changes,height growth,Weight gain and bone mineral content of two groups were compared.Results The FEV1 and FEV1/FVC,IgM,IgG and IgA level were significantly higher in the observation group than those in the con-trol group(P<0·05).The percentage of CD4+,CD8+,CD4+/CD8+in the observation group were higher than that in the control group(P<0·05).The height growth weight gain and bone mineral content was lower than those of the control group(P<0·05).Conclusion Inhalation of small doses of budesonide in children with asth-ma can improve the lung function and improve the immunity of children,but it can affect the growth and develop-ment of the body.Therefore,we should pay attention to the pros and cons in the clinical use.