目的 觀察孟魯司特鈉聯(lián)合重組人干擾素α-2b對呼吸道合胞病毒（RSV）致毛細(xì)支氣管炎患兒淋巴細(xì)胞Th1/Th2亞群的影響和臨床療效。方法 選取2018年2月-2019年10月徐州醫(yī)科大學(xué)附屬淮安醫(yī)院兒科收治的RSV致毛細(xì)支氣管炎患兒224例，采用隨機(jī)數(shù)表法分為對照組和觀察組，每組各112例。對照組給予重組人干擾素α-2b注射液，1 000萬IU/m²肌肉注射，1次/d。觀察組在對照組基礎(chǔ)上加用孟魯司特鈉，1歲以上患兒給予孟魯司特鈉咀嚼片5 mg/次，1次/d。1歲以下小兒給予孟魯司特鈉顆粒，4 mg/次，溫水送服，1次/d。兩組均連續(xù)治療3 d。觀察兩組患者的臨床療效和臨床癥狀改善情況，同時比較兩組患兒治療前后的淋巴細(xì)胞亞群、白細(xì)胞介素-4（IL-4）和γ-干擾素（IFN-γ）水平。結(jié)果 治療后，觀察組臨床治療總有效率為92.9%，顯著高于對照組的77.7%（P<0.05）。治療后，觀察組呼吸困難、肺部啰音、咳嗽及憋喘消失時間和住院時間均顯著短于對照組（P<0.05）。治療后，兩組Th1細(xì)胞比例均顯著升高，Th2細(xì)胞比例均顯著減低（P<0.01）。治療后，觀察組Th1細(xì)胞比例顯著高于對照組，而Th2細(xì)胞比例顯著低于對照組（P<0.01）。治療后，兩組IFN-γ水平均顯著升高，IL-4水平均顯著減低（P<0.01）。治療后，觀察組IFN-γ水平顯著高于對照組，而IL-4水平顯著低于對照組（P<0.01）。結(jié)論 孟魯司特鈉聯(lián)合重組人干擾素α-2b治療RSV致毛細(xì)支氣管炎患兒，可顯著增加Th1細(xì)胞和IFN-γ細(xì)胞因子水平，降低Th2細(xì)胞和IL-4水平，且臨床療效顯著。

Objective To observe the effect of montelukast sodium combined with recombinant human interferon α -2b on lymphocyte Th1/Th2 subsets in children with bronchiolitis caused by respiratory syncytial virus (RSV) and explore its clinical efficacy. Methods Children (224 cases) with RSV induced bronchiolitis in Huaian Hospital Affiliated to Xuzhou Medical University from February 2018 to October 2019 were randomly divided into control group and observation group, with 112 cases in each group. Children in the control group were given Interferon α -2b injection, 1 000 IU/m² intramuscular injection, once daily. Children over 1 year old in the observation group were given Montelukast Sodium Chewable Tablets on the basis of control group, 5 mg/time, once daily, children under 1 year old were given Montelukast Sodium Oral Granules in warm water, 4 mg/time, once daily. Both groups were treated continuously for 3 d. The clinical efficacy and improvement of clinical symptoms in two groups were observed, and the levels of lymphocyte subsets, IL-4, and IFN-γ before and after treatment were compared. Results After treatment, the total effective rate was 92.9% in the observation group, which was significantly higher than 77.7% in the control group (P<0.05). After treatment, the time of dyspnea, lung rale, cough, suffocation disappearance, and hospitalization in the observation group were significantly shorter than those in the control group (P<0.05). After treatment, the proportion of Th1 cells in two groups were increased significantly, while the proportion of Th2 cells were decreased (P<0.01). After treatment, the proportion of Th1 cells in the observation group was significantly higher than that in the control group, while the proportion of Th2 cells was significantly lower than that in the control group (P<0.01). After treatment, the levels of IFN-γ in two groups were significantly increased, but the levels of IL-4 were significantly decreased (P<0.01). After treatment, IFN-γ level in the observation group was significantly higher than that in the control group, while IL-4 level was significantly lower than that in the control group (P<0.01). Conclusion Monteluast sodium combined with interferon α-2b in treatment of children with RSV-induced bronchiolitis can significantly increase the levels of Th1 cells and IFN-γ, and reduce the levels of Th2 cells and IL-4, with significant clinical effect.

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