ABSTRACT
Objective To investigate the therapeutic effects of salmeterol xinafoate and fluticasone propio-nate powder(seretide) in combination with montelukast on children with cough variant asthma (CVA),and its effect on pulmonary function and serum inflammatory cytokines .Methods 200 patients with CVA were enrolled ,and they were randomly divided into two groups according to the random number table ,100 cases in each group .The control group was treated with seretide ,while the observation group was treated with seretide and montelukast sodium ,both two groups were treated for 3 months.The clinical efficacy,pulmonary function and serum inflammatory cytokines were compared between the two groups .Results The total effective rate of the observation group ( 88.3％) was significantly higher than that of the control group (70.3％;χ2 =9.146,P<0.05).The duration of remission and disappearance of cough symptoms in the observation group were (5.45 ±1.32) d,(8.63 ±1.96) d,respectively, which were significantly shorter than those in the control group [(7.33 ±2.46) d,(12.61 ±1.84) d;t =6.505, 14.229,all P<0.05].There were no statistically significant differences in FEV 1,FEV1/FVC,PEF,IgE,TNF-αand IL-17 between the two groups before treatment (all P>0.05).After treatment,the levels of FEV1,FEV1/FVC, PEF were all significantly higher than those before treatment [(2.11 ±0.34) L,(73.71 ±11.44)％,(86.34 ± 7.85)％,t=18.149,7.664,19.196,all P<0.05;(1.82 ±0.35)L,(69.36 ±10.79)％,(81.66 ±8.03)％,t=9.312,5.418,13.627,all P <0.05],and IgE,TNF -α,IL -17 levels were significantly decreased [(141.3 ± 38.2)ng/L,(624.7 ±213.2) ng/L,(6.1 ±2.1) ng/L,t =15.200,13.708,15.881,all P <0.05;(191.5 ±41.9) ng/L,(835.5 ±326.3)ng/L,(9.4 ±2.7) ng/L,t=6.784,6.206,8.550,all P<0.05].The differences between the two groups were statistically significant(t=5.717,2.659,4.008,8.521,4.842,9.296,all P<0.05). Conclusion Salmeterol xinafoate and fluticasone propionate powder in combination with montelukast sodium has excellent clinical effect in the treatment of children with CVA ,which can improve the pulmonary function and reduce inflammatory cytokines .
ABSTRACT
Objective To study the expression of hypoxia-inducible factor-1 α (HIF-1 α) in children with attention deficit hyperactivity disorder(ADHD),and its relationship with respiratory function.Methods Sixty children with ADHD confirmed by DSM-IV were admitted as ADHD group.60 healthy children were selected as the normal control group.The serum level of HIF-1α was determined by enzyme-linked immunosorbent assay(ELISA).Respiratory rate and respiratory amplitude were measured by biofeedback instrument.The PEF was measured by peak speed meter.The differences of HIF-1 α level and respiratory function between different ADHD groups and control group were analyzed.The influence of age and sex on HIF-1 α level and respiratory function was analyzed.Results The serum levels of HIF-1 α in ADHD group and healthy control group were (43.22-± 11.68) ng/L and (21.48 ± 12.70)ng/L respectively,the respiration rates were (17.47 ±-2.82)/min and (15.28 ± 2.35)/min respectively.The HIF-1 α and respiration rate of ADHD group were higher than healthy control group (t =9.003,4.363,all P ＜ 0.05).The respiratory amplitude in ADHD group and healthy control group were (2.36 ± 1.18) cm and (3.03 ± 1.05)cm respectively,the PEF in the two groups were (191.42 ± 30.06) L/min and (206.62 ± 33.35) L/min respectively.The respiratory amplitude and PEF of ADHD group were lower than healthy control group (t =4.007,8.534,all P ＜0.05).There were no significant differences in HIF-1α level,respiratory rate,respiratory amplitude and PEF between boys and girls with ADHD (P ＞ 0.05).There were no significant differences in HIF-1 α level,respiratory rate,respiration amplitude and PEF between different age in ADHD children (P ＞ 0.05).There was a negative correlation between HIF-1 α and PEF in children with ADHD (r =0.422,P ＜ 0.05).Conclusion HIF-1 α and lung function are correlated with ADHD,ADHD children have small lung capacity,which may result in the hypoxia of the brain and the increase of HIF-1 α expression.