孟鲁司特钠联合细辛脑注射液治疗小儿毛细支气管炎前后髓系抑制细胞、IL-12、IL-1O水平变化分析

目的观察孟鲁司特钠联合细辛脑注射液治疗小儿毛细支气管炎前后髓系抑制细胞（myeloidderivedsuppressorcells，MDSCs）、IL-10、IL12的变化，探讨药物作用机制。方法2012年1月至2014年4月收治的107例急性发作毛细支气管炎患儿为研究对象，根据有无特应质分为特应质组（52例）、非特应质组（55例），两组在对症疗法基础上，静滴细辛脑注射液并口服孟鲁司特钠咀嚼片，检测治疗前、治疗5d后、治疗7d后患儿外周血MDSDs占外周血单核细胞比例、血清IL-10、IL-12水平并记录变化情况，治疗7d后判定临床疗效。结果特应质组患儿治疗前、治疗5d、7d后MDSCs分别为（2．87±0．24）％、（1．55±0．20）％、（0．87±0．21）％，IL-10分别为（27．81土4．95）ng／L、（19．64±4．16）ng／L、（13．62±2．97）ng／L；非特应质组MDSC％分别为（1．52±0．25）％、（1．07±0．21）％、（0．84±0．16）％，IL-10分别为（21．56±4．07）ng／L、（18．35±4．24）ng／L、（14．37±3．82）ng／L，特应质组MDSCs、IL-10下降趋势更为明显。特应质组治疗前、治疗5d、7d后IL-12分别为（33．74±7．26）ng／L、（46．53±6．12）ng／L（54．32±8．65）ng／L，非特应质组IL-12水平相对稳定（P〉0．05）。治疗7d后，特应质组与非特应质组患儿总体疗效构成（Z=0．788，P=0．431）及临床总体有效率（96．2％VS92．7％，P=0．679）差异无统计学意义。结论孟鲁司特钠联合细辛脑注射液治疗合胞病毒感染小儿毛细支气管炎可下调MDSCs、IL-10水平，上调IL-12水平，可能通过恢复体内Thl／Th2细胞失衡发挥作用，这种通路机制在特应质患儿表现得更为典型。

Study on variation of myeloid derived suppressor cells,interleukin-12, interleukin-lO levels of children withbronchiolitis after treatment with montelukast sodium and asarone injection

Objective To observe variations on myeloid derived suppressor cells （MDSCs）, interleukin-10 （IL-10）,and IL-12 of children with respiratory syncytial virus （RSV） infected bronchiolitis after treated with montelukast sodium combined with asarone injection, and to explore the mechanism of drug action. Methods 107 cases from January 2012 to April 2014 were enrolled as study objects,and were divided into atopic group （52 cases） and non atopic group （55 cases）according to allergy characteristics. The two groups were applied with symptomatic therapy,besides,intravenous drip of asarone injection and oral use of montelukast sodium chewable tablets were added. MDSCs proportion in peripheral blood mononuclear cells,serum IL-10 and ILl2 levels were measured before treatment and after treatment for 5 d,7 d, finally, clinical efficacy was determined after treatment for 7 d. Results MDSCs proportion in atopic group before treatment and after treatment for 5 d,7 d was （2.87±0.24）%, （1.55±0.20）%,and （0.87±0.21） %,IL-10 level was （27.81±4.95） ng/L,（19.64±4.16） ng/L,and （13.62±2.97） ng/L. MDSCs proportion in non atopic group was （1.52±0.25）%, （1.07±0.21）% ,and （0.84±0.16）%, IL-10 level was （21.56±4.07） ng/L,（18. 35±4. 24） ng/L,and （14.37±3.82） ng/L. MDSCs proportion and IL-10 level in atopic group decreased more obviously. IL-12 level in atopic group before treatment and after treatment for 5 d,7 d was （33.74±7.26） ng/L, （46.53±6.12） ng/L,and （54.32±8.65） ng/L,IL-12 level in non atopic group was relatively stable （ P 〉0.05）. After treatment for 7 d, there was no significant difference in efficacy constitution （ Z = 0. 788, P = 0. 431） and overall clinical effective rate （96.2% vs 92.7%, P = 0. 679） between atopic group and non atopic group. Conclusions Montelukast sodium combined with asarone injection treating RSV related bronchiolitis can downregulate MDSCs proportion and IL-10 level, whereas IL-12 level increases, possibl