孟鲁司特治疗儿童咳嗽变异性哮喘的临床研究

发布时间：2018-06-10 20:19

本文选题：白三烯受体拮抗剂 + 孟鲁司特　；参考：《中国药房》2017年29期

【摘要】：目的:探讨白三烯受体拮抗剂孟鲁司特治疗儿童咳嗽变异性哮喘对患儿炎症因子、气道解剖学和肺功能指标等的影响。方法:选取2010年4月-2015年8月我院收治的咳嗽变异性哮喘患儿86例,按照随机数字表法分为对照组与观察组,各43例。对照组患儿给予布地奈德气雾剂0.4 mg,bid;观察组患儿给予孟鲁司特钠咀嚼片,根据不同年龄选择不同剂量(2~6岁给予4 mg,tid;7~12岁给予5 mg,tid)。两组患儿均以4周为1个疗程,持续治疗2个疗程。检测两组患儿治疗前后的炎症因子水平、气道解剖学和肺功能指标,并观察不良反应发生情况。结果:治疗前,两组患儿上述各项指标比较,差异均无统计学意义(P0.05)。与治疗前比较,治疗后两组患儿的白细胞介素4(IL-4)、IL-6、IL-8、肿瘤坏死因子α和超敏C反应蛋白水平均显著降低,气道壁厚度、基底膜厚度、气道壁厚度/外径比、气道壁总面积和气道壁总面积/气道总面积均显著减小,用力肺活量(FVC)、1 s用力呼气容量(FEV1)和FEV1/FVC均显著增大,最大呼气流速显著加快,且观察组各指标水平均显著优于对照组,差异均有统计学意义(P0.05)。两组患儿的不良反应发生率比较,差异无统计学意义(P0.05)。结论:孟鲁司特治疗儿童咳嗽变异性哮喘对改善患儿炎症反应、气道状态及肺功能的效果显著,且具有较高的安全性。
[Abstract]:Aim: to investigate the effects of montelukast, a leukotriene receptor antagonist, on inflammatory factors, airway anatomy and pulmonary function in children with cough variant asthma. Methods: 86 children with cough variant asthma admitted in our hospital from April 2010 to August 2015 were divided into control group (n = 43) and observation group (n = 43). The patients in the control group were given budesonide aerosol 0.4 mg bid, and those in the observation group were given montelukast sodium chewable tablets, and 4 mg of tidtidine was given at the age of 712 years according to the different dosage of montelukast sodium chewable tablet. The two groups were treated with 4 weeks as a course of treatment and 2 courses of continuous treatment. The levels of inflammatory factors, airway anatomy and pulmonary function were measured before and after treatment, and adverse reactions were observed. Results: before treatment, there was no significant difference in the above indexes between the two groups (P 0.05). Compared with those before treatment, the levels of IL-6 / IL-8, tumor necrosis factor 伪 and hypersensitive C-reactive protein were significantly decreased in the two groups after treatment. The thickness of airway wall, the thickness of basement membrane, the ratio of thickness of airway wall to diameter of airway wall were significantly decreased. The total area of the airway wall and the total area of the airway wall / the total area of the airway decreased significantly. The forced vital capacity and FEV1 / FVC of forced expiratory volume and FEV1 / FVC increased significantly, and the maximal expiratory flow rate increased significantly, and each index level of the observation group was significantly better than that of the control group. The difference was statistically significant (P 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion: montelukast is effective in improving inflammatory response, airway status and lung function in children with cough variant asthma.
【作者单位】：滨州医学院附属医院儿内科;
【分类号】：R725.6

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