Gong L, Xu L, Diao M, Guo F, Bian F-F, Min J, Liu R, Zhang C-L
Department of Respiratory Medicine, Xuzhou Children's Hospital, Xuzhou, Jiangsu, China.
Eur Rev Med Pharmacol Sci. 2016 Dec;20(24):5256-5260.
To discuss the clinical effects of treating secondary asthma attacks of children Mycoplasma pneumoniae with combined therapy of montelukast and azithromycin.
96 children patients diagnosed with secondary asthma attacks of Mycoplasma pneumonia were enrolled in this study. They were randomly divided into two groups: the control group (n=49) and the observation group (n=47). Patients in the control group received combined therapy using azithromycin and bronchodilators or glucocorticoid, and patients in the observation group received a combined therapy of montelukast, azithromycin and bronchodilators or glucocorticoid. The lung function indexes, T lymphocyte subpopulation, cytokines levels, positive rate of lgG and lgM, asthma control rate and recurrence rate were compared between groups before and after treatment.
The levels of V-T, t-PTEF/t-E, MTIF/MTEF and TEF25/PTEF in both groups increased after treatment, but we observed a more significant improvement in the observation group. The CD4+ and CD4+/CD8+ levels in both groups also increased after the intervention, while the level of CD8+ decreased. The IL-10, IL-17 and TGF-β levels decreased more intensely in the observation group.
The positive rate of lgG and lgM in both groups decreased significantly after the intervention. In the observation group, the asthma control rate was higher while the recurrence rate was lower. Although montelukast had little effect on improving the immune function, it was certainly beneficial for controlling the symptoms of asthma and improving the prognosis.
Using combined therapy of montelukast and azithromycin for treating the secondary asthma attacks of children mycoplasma pneumonia can relieve immunological and inflammatory reactions and improve the lung function.
探讨孟鲁司特与阿奇霉素联合治疗儿童支原体肺炎继发哮喘发作的临床效果。
本研究纳入96例诊断为支原体肺炎继发哮喘发作的儿童患者。将他们随机分为两组：对照组（n = 49）和观察组（n = 47）。对照组患者接受阿奇霉素与支气管扩张剂或糖皮质激素的联合治疗，观察组患者接受孟鲁司特、阿奇霉素与支气管扩张剂或糖皮质激素的联合治疗。比较两组治疗前后的肺功能指标、T淋巴细胞亚群、细胞因子水平、IgG和IgM阳性率、哮喘控制率及复发率。
两组治疗后V - T、t - PTEF/t - E、MTIF/MTEF和TEF25/PTEF水平均升高，但观察组改善更显著。两组干预后CD4 +和CD4 +/CD8 +水平也升高，而CD8 +水平降低。观察组IL - 10、IL - 17和TGF -β水平下降更明显。
两组干预后IgG和IgM阳性率均显著下降。观察组哮喘控制率较高而复发率较低。孟鲁司特虽然对改善免疫功能作用不大，但对控制哮喘症状及改善预后肯定有益。
孟鲁司特与阿奇霉素联合治疗儿童支原体肺炎继发哮喘发作可缓解免疫和炎症反应，改善肺功能。
