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目的观察咳嗽变异性哮喘儿童肺泡灌洗液IL-5变化及孟鲁司特对其调节作用。方法 60例咳嗽变异性哮喘患儿随机分为A、B组各30例,对照组30例为同期行支气管镜检查的健康儿童,A组给予常规治疗,并予布地奈德雾化1 mg一天2次,治疗4周;B组在A组治疗基础上予孟鲁司特5 mg口服每晚1次,疗程为4周。观察治疗前后肺泡灌洗液IL-5变化。结果治疗前A、B组IL-5水平比较,差异无统计学意义(P>0.05),与对照组比较,差异有显著性(P<0.01);治疗后A、B组IL-5比较,差异有统计学意义(P<0.01)。BALF中IL-5浓度与FEV1/FVC和EOS呈明显相关(P<0.01)。结论咳嗽变异性哮喘肺泡灌洗液IL-5显著增高,孟鲁司特能降低BALF中IL-5水平,其水平对于咳嗽变异哮喘诊断和治疗有重要意义。
Objective To observe the changes of IL-5 in bronchoalveolar lavage fluid in children with cough variant asthma and the effect of montelukast on it. Methods Sixty children with cough variant asthma were randomly divided into A group and B group, 30 cases in the control group, 30 cases in the control group were treated by bronchoscopy in the same period. Group A received conventional treatment and were given Budesonide for 1 mg a day 2 times for 4 weeks. Group B received montelukast 5 mg orally once night for 4 weeks on the basis of group A treatment. The changes of IL-5 in bronchoalveolar lavage fluid before and after treatment were observed. Results There was no significant difference in IL-5 level between A and B groups before treatment (P> 0.05), but there was significant difference between A and B groups (P <0.01) The difference was statistically significant (P <0.01). IL-5 concentration in BALF was significantly correlated with FEV1 / FVC and EOS (P <0.01). CONCLUSION: IL-5 in bronchoalveolar lavage fluid of cough-variant asthma is significantly higher than that of montelukast, and IL-5 in BALF can be decreased by montelukast. The level of IL-5 in BALF may play an important role in the diagnosis and treatment of asthma with cough variant.