孟鲁司特钠对肺炎支原体肺炎疗效及细胞因子的影响

孙明月; 郭普; 夏群; 彭万胜

doi:10.16766/j.cnki.issn.1674-4152.004046

孟鲁司特钠对肺炎支原体肺炎疗效及细胞因子的影响

doi: 10.16766/j.cnki.issn.1674-4152.004046

孙明月^{1, 2},
郭普³,
夏群¹,
彭万胜^1, ,

1.
蚌埠医科大学第一附属医院儿科，安徽蚌埠 233004
2.
蚌埠市第三人民医院儿科，安徽蚌埠 233000
3.
蚌埠医科大学第一附属医院检验科

基金项目:

安徽高校自然科学研究项目重点项目 KJ2021A0761

蚌埠医科大学自然科学类重点项目 2023byzd085

详细信息

通讯作者:
彭万胜，E-mail：pws2007@126.com

中图分类号: R563.15
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- 文章访问数: 16
- HTML全文浏览量: 7
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-12
- 网络出版日期: 2025-09-04

Effect of montelukast sodium on the efficacy of Mycoplasma pneumoniae pneumonia and cytokines

SUN Mingyue^{1, 2},
GUO Pu³,
XIA Qun¹,
PENG Wansheng^{1
, ,}

1.
Department of Pediatrics, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的为了研究如何更有效地治疗肺炎支原体肺炎(MPP)，在抗感染的基础上，加用孟鲁司特钠，研究其对MPP疗效及血清白三烯、白介素4(IL-4)、γ干扰素(IFN-γ)的影响，并分析上述细胞因子与MPP的关系。方法选择2022年4—12月蚌埠医科大学第一附属医院收治的90例MPP患儿(57例轻症，33例重症)，按住院当日入院次序的单双号分为对照组(抗感染)和研究组(抗感染加用孟鲁司特钠)，各45例。比较2组疗效、不良反应及治疗前后细胞因子水平变化，比较上述细胞因子与MPP严重程度的关系。结果治疗7 d后，研究组咳嗽评分、热退时间及住院时长均低于对照组，临床有效率(43例，95.5%)高于对照组(36例，80.0%)，差异有统计学意义(P＜0.05)；2组不良反应发生率差异无统计学意义(P＞0.05)。治疗7 d后，2组血清白三烯、IL-4水平均低于治疗前，IFN-γ水平均高于治疗前(P＜0.05)，且研究组血清白三烯、IL-4水平低于对照组，IFN-γ水平高于对照组(P＜0.05)。轻症MPP血清白三烯、IL-4水平低于重症支原体肺炎(SMPP)，IFN-γ水平高于SMPP(P＜0.05)。相关性分析显示，MPP严重程度与血清白三烯、IL-4水平呈正相关关系(r_s=0.725、0.798，均P < 0.001)，与IFN-γ水平呈负相关关系(r_s=-0.746，P < 0.001)。结论孟鲁司特钠治疗MPP具有较好的疗效，可调节Th1/Th2细胞因子失衡，且安全性较高；MPP严重程度与血清白三烯、IL-4水平呈正相关关系，与IFN-γ水平呈负相关关系。
- 肺炎支原体肺炎 /
- 孟鲁司特钠 /
- 疗效 /
- 细胞因子
Abstract: Objective In order to study how to treat Mycoplasma pneumoniae pneumonia (MPP) more effectively, montelukast sodium is added on the basis of anti-infection to study its effects on the efficacy of MPP and serum leukotrienes, interleukin 4 (IL-4), and interferon γ (IFN-γ), and to analyze the relationship between the above cytokines and MPP. Methods Ninety cases of children with MPP (57 mild cases, 33 severe cases) admitted to the First Affiliated Hospital of Bengbu Medical University from Aprial to December 2022 were selected and divided into a control group (anti-infective) and a study group (anti-infective add montelukast sodium) according to the single or double number of the order of admission on the day of hospitalization, with 45 cases in each group. The efficacy, adverse effects, and changes in cytokine levels before and after treatment between the two groups were compared, and the relationship between the above cytokines and the severity of MPP was compared. Results After 7 days of treatment, the study group showed lower scores in cough assessment, shorter fever resolution time, and reduced hospitalization duration compared to the control group. The clinical effectiveness rate was higher in the study group (43 cases, 95.5%) than in the control group (36 cases, 80.0%), with a statistically significant difference (P < 0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). After 7 days of treatment, both groups showed decreased serum levels of leukotrienes and IL-4 and increased IFN-γ levels compared to pre-treatment values (P < 0.05). Moreover, the study group exhibited significantly lower serum leukotriene and IL-4 levels and higher IFN-γ levels than the control group (P < 0.05). Patients with mild MPP had significantly lower serum leukotriene and IL-4 levels but higher IFN-γ levels compared to those with severe MPP (P < 0.05). Correlation analysis showed that the severity of MPP was positively correlated with the levels of serum leukotrienes and IL-4 (r_s=0.725, 0.798, both P < 0.001), and negatively correlated with the level of IFN-γ (r_s=-0.746, P < 0.001). Conclusion Montelukast sodium has good efficacy in treating MPP, which can regulate Th1/Th2 cytokine imbalance and has high safety. The severity of MPP is positively correlated with serum leukotriene and IL-4 levels, and negatively correlated with IFN-γ levels.
- Mycoplasma pneumoniae pneumonia /
- Montelukast sodium /
- Efficacy /
- Cytokines

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表 1 2组MPP患儿一般资料比较

Table 1. Comparison of general data between the two groups of children with MPP

组别	例数	性别(男性/女性，例)	年龄[M(P₂₅, P₇₅), 岁]	疾病严重程度[例(%)]
组别	例数	性别(男性/女性，例)	年龄[M(P₂₅, P₇₅), 岁]	轻症MPP	SMPP
研究组	45	24/21	5.2(3.9, 7.1)	28(62.2)	17(37.8)
对照组	45	17/28	4.7(3.3, 6.3)	29(64.4)	16(35.6)
统计量		2.195^a	-0.989^b	0.048^a
P值		0.138	0.323	0.827
注：^a为χ²值，^b为Z值。

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表 2 咳嗽症状评分标准

Table 2. Cough symptom scoring criteria

评分(分)	日间咳嗽评分	夜间咳嗽评分
0	无咳嗽	无咳嗽
1	偶有咳嗽	轻度咳嗽不影响睡眠
2	咳嗽较多，不影响日常生活	夜间咳嗽发作觉醒1~2次
3	咳嗽剧烈，严重影响日常生活	夜间咳嗽发作觉醒≥3次
注：咳嗽评分总分＝日间咳嗽评分+夜间咳嗽评分。

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表 3 2组MPP患儿临床观察指标比较[M(P₂₅, P₇₅)]

Table 3. Comparison of clinical observation indexes between the two groups of children with MPP [M(P₂₅, P₇₅)]

组别	例数	咳嗽评分(分)		热退时间(d)	住院时长(d)
组别	例数	治疗前	治疗7 d后	热退时间(d)	住院时长(d)
研究组	45	4.0(4.0, 5.0)	2.0(1.0, 2.0)^a	3.0(2.0, 3.5)	7.0(6.0, 10.5)
对照组	45	4.0(3.5, 5.0)	2.0(2.0, 3.0)^a	3.0(2.5, 4.5)	8.0(7.0, 11.5)
Z值		-0.820	-2.561	-2.405	-2.237
P值		0.412	0.010	0.016	0.025
注：与同组治疗前比较，^aP＜0.05。

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表 4 2组MPP患儿治疗前后细胞因子水平比较(x ±s)

Table 4. Comparison of cytokine levels between the two groups of children with MPP before and after treatment (x ±s)

组别	例数	白三烯(ng/mL)		IL-4(pg/mL)		IFN-γ(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	45	13.78±0.63	5.64±0.62^b	25.71±1.85	14.85±1.38^b	166.94±9.51	216.17±9.87^b
对照组	45	13.54±0.82	8.40±0.54^b	25.61±1.73	18.32±1.33^b	168.00±9.30	192.70±10.64^b
统计量		1.515^a	638.997^c	0.273^a	155.560^c	0.534^a	119.803^c
P值		0.133	＜0.001	0.786	＜0.001	0.594	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 5 轻症MPP与SMPP患儿治疗前细胞因子水平比较

Table 5. Comparison of cytokine levels between children with mild MPP and SMPP before treatment

组别	例数	白三烯[M(P₂₅, P₇₅)，ng/mL]	IL-4 [M(P₂₅, P₇₅)，pg/mL]	IFN-γ (x ±s，pg/mL)
轻症MPP	57	13.40(12.92, 13.72)	24.61(23.63, 25.40)	172.62±6.54
SMPP	33	14.33(14.01, 14.76)	27.70(26.63, 28.31)	158.57±6.36
统计量		-6.837^a	-7.532^a	9.920^b
P值		< 0.001	< 0.001	< 0.001
注：^a为Z值，^b为t值。

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表 6 2组MPP患儿不良反应发生率比较[例(%)]

Table 6. Comparison of the incidence of adverse reactions between the two groups of children with MPP [cases (%)]

组别	例数	腹痛	腹泻	恶心、呕吐	头痛、头晕	过敏反应	合计
研究组	45	1(2.22)	2(4.44)	2(4.44)	0	0	5(11.10)
对照组	45	1(2.22)	1(2.22)	1(2.22)	1(2.22)	0	4(8.88)
注：2组不良反应总发生率比较，χ²＜0.001，P=0.999。

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