目的 观察孟鲁司特钠联合重组人干扰素α-2b对呼吸道合胞病毒（RSV）致毛细支气管炎患儿淋巴细胞Th1/Th2亚群的影响和临床疗效。方法 选取2018年2月-2019年10月徐州医科大学附属淮安医院儿科收治的RSV致毛细支气管炎患儿224例，采用随机数表法分为对照组和观察组，每组各112例。对照组给予重组人干扰素α-2b注射液，1 000万IU/m²肌肉注射，1次/d。观察组在对照组基础上加用孟鲁司特钠，1岁以上患儿给予孟鲁司特钠咀嚼片5 mg/次，1次/d。1岁以下小儿给予孟鲁司特钠颗粒，4 mg/次，温水送服，1次/d。两组均连续治疗3 d。观察两组患者的临床疗效和临床症状改善情况，同时比较两组患儿治疗前后的淋巴细胞亚群、白细胞介素-4（IL-4）和γ-干扰素（IFN-γ）水平。结果 治疗后，观察组临床治疗总有效率为92.9%，显著高于对照组的77.7%（P<0.05）。治疗后，观察组呼吸困难、肺部啰音、咳嗽及憋喘消失时间和住院时间均显著短于对照组（P<0.05）。治疗后，两组Th1细胞比例均显著升高，Th2细胞比例均显著减低（P<0.01）。治疗后，观察组Th1细胞比例显著高于对照组，而Th2细胞比例显著低于对照组（P<0.01）。治疗后，两组IFN-γ水平均显著升高，IL-4水平均显著减低（P<0.01）。治疗后，观察组IFN-γ水平显著高于对照组，而IL-4水平显著低于对照组（P<0.01）。结论 孟鲁司特钠联合重组人干扰素α-2b治疗RSV致毛细支气管炎患儿，可显著增加Th1细胞和IFN-γ细胞因子水平，降低Th2细胞和IL-4水平，且临床疗效显著。

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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