孟鲁司特钠对毛细支气管炎患儿血嗜酸粒细胞及半胱氨酰白三烯的影响

Effects of montelukast Na on blood eosinophil and cysteiny LTs in infants with respiratory syncytial virus bronchiolitis

目的 探讨孟鲁司特钠（顺尔宁）对呼吸道合胞病毒（RSV）毛细支气管炎患儿血嗜酸粒细胞及半胱氨酰白三烯（CysLTs）的影响并观察其疗效。方法 将60例6～18个月的RSV毛细支气管炎患儿随机分为顺尔宁治疗组（30例）和常规治疗组（30例），常规治疗组仅给予常规治疗；而顺尔宁治疗组在常规治疗的基础上，1次／d口服2．5mg顺尔宁，疗程1周；于治疗前和治疗7d后检测血嗜酸粒细胞计数和CysLTs水平，并观察两组疗效及症状、体征恢复正常时间。结果 治疗前，RSV毛细支气管炎各组血嗜酸粒细胞计数和CysLTs水平均明显高于正常组（P〈0．01）；治疗后，顺尔宁治疗组症状和体征恢复正常时间均比常规治疗组为早（P〈0．01），同时血嗜酸粒细胞计数和CysLTs水平较常规治疗组显著下降（P〈0．05），与正常组比较差异无统计学意义（P〉0.05），常规治疗组患儿血嗜酸粒细胞计数和CysLTs水平仍高于正常组（P〈0．05）。结论 顺尔宁能降低RSV毛细支气管炎患儿血嗜酸粒细胞计数和CysLTs水平，在RSV毛细支气管炎的抗炎机制中起重要作用，可缩短病程，对疾病康复有明显促进作用。

Objective To investigate the effects of montelukast Na on serum eosinophil counting and cysteiny LTs（CysLTs） in infants with respiratory syncytial virus（RSV） bronchiolitis and the therapeutic effects. Methods 60 infants with RSV bronchiolitis aged 6-18 months were randomly divided into two groups：the montelukast treated group（ 30 cases）and routine treated group （30 cases）. The patient in routine treated group were treated by routine complex treatment;on the basis of routine complex treatment,the patient in montelukast treated group were used montelukast Na, taking 2. 5 mg once daily orally montelukast Na,with a treatment course of 7 days. 20 health infants were served as normal control group. Before starting treatment and 7 days later, clinical effects were observed ; concentration of serum CysLTs was measured ; also blood esoinophil was counted. Results Before treatment,the level of CysLTs and eosinophil counting in patients with RSV bronchiolitis was significantly higher than that in normal control group（ P 〈 0.01 ）. After treatment, the time that patients＇ symptoms and signs returned to normal state was obviously earlier in montelukast treated group than that in routine treated group（ P 〈 0. 01 ） ; eosinophil counting and CysLTs level decreased significantly in montelukast treated group compared with that in routine treated group （ P 〈 0.05 ） ; there were no significantly difference in eosinophil counting and CysLTs level both montelukast treated group and normal control group （ P 〉 0. 05 ） ; eosinophil counting and CysLTs level was higher significantly in routine treated group compared with that in normal control group（ P 〈 0.05 ）. Conclusion Montelukast Na can lower the level of CysLTs and eosinophil counting in serum of RSV bronchiolitis patients,which plays an important role for antagonizing airway inflammation of RSV bronchiolitis,meanwhile it can reduce course of the illness and possess the obviously promoter action to disease recovery, too.