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孟鲁司特治疗儿童咳嗽变异性哮喘的临床研究
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| 篇名： | 孟鲁司特治疗儿童咳嗽变异性哮喘的临床研究 |
| TITLE： | |
| 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（P＞0.05）。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（P＜0.05）。两组患儿的不良反应发生率比较，差异无统计学意义（P＞0.05）。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： | OBJECTIVE： To investigate the effects of leukotriene receptor antagonist montelukast on inflammatory factor， airway anatomy and lung function of children with cough variant asthma. METHODS： A total of 86 children with cough variant asthma selected from our hospital during Apr. 2010 to Aug. 2015 were divided into control group and observation group according to random number table， with 43 cases in each group. Control group was given Budesonide aerosol 0.4 mg， bid； observation group was given Montelukast sodium chewable tablets with different dose according to age （4 mg for 2-6 year-old， tid； 5 mg for 7-12 year-old， tid）. A treatment course of 2 groups lasted for 4 weeks， and both groups received 2 courses of treatment. The levels of inflammatory factor， airway anatomy and lung function indexes were detected in 2 groups before and after treatment， and the occurrence of ADR was also observed. RESULTS： Before treatment， there was no statistical significance in above indexes between 2 groups （P＞0.05）. Compared to before treatment， the levels of IL-4， IL-6， IL-8， TNF-α and hs-CRP in 2 groups were decreased significantly after treatment； airway wall thickness， basement membrane thickness， airway wall thickness/outside diameter ratio， total area of airway wall， total area of airway wall/total area of airway were decreased significantly， while FVC， FEV1， FEV1/FVC， PEF were increased significantly； the indexes in observation group were significantly better than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： For pediatric cough variant asthma， montelukast can significantly improve inflammatory reaction， airway status and lung function with good safety. |
| 期刊： | 2017年第28卷第29期 |
| 作者： | 张鑫雨，马莲美，李晓梅，李得志 |
| AUTHORS： | ZHANG Xinyu，MA Lianmei，LI Xiaomei，LI Dezhi |
| 关键字： | 白三烯受体拮抗剂；孟鲁司特；儿童；咳嗽变异性哮喘；气道解剖学；炎症；肺功能 |
| KEYWORDS： | Leukotriene receptor antagonist； Montelukast； Children； Cough variant asthma； Airway anatomy； Inflammation； Lung function |
| 阅读数： | 235 次 |
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