孟鲁司特钠对呼吸道合胞病毒毛细支气管炎后气道炎症的作用

The effect of montelukast on the treatment of airway inflammation in bronchiolitis after respiratory syncytial virus infection

目的通过检测炎性因子嗜酸性粒细胞阳离子蛋白(ECP)、IL-8、一氧化氮(NO)的变化及临床表现,探讨孟鲁司特钠对呼吸道合胞病毒毛细支气管炎(RSV毛支)后气道炎症的影响。方法选择142例初次喘息发作的具有特应性体质的RSV毛支患儿为研究对象,常规治疗症状控制后,随机分成3组:A组孟鲁司特钠口服,B组布地奈德气雾吸入,C组为空白对照,分别在住院当日、干预前、干预3个月后检测血清中ECP、IL-8及NO的浓度,门诊及电话随访1年。采用SPSS15.0软件包完成数据统计分析。结果3个月内喘息再次发作人数及1年后哮喘发生情况,A组与C组比较,差异有统计学意义;B组与C组比较,差异无统计学意义。各组用药后ECP及NO下降幅度,A组较大,与B组比较差异有统计学意义;IL-8下降水平,A组与B组比较差异无统计学意义。结论孟鲁司特钠对RSV毛支患儿的炎性细胞因子ECP、IL-8、NO有下调作用;对哮喘的预防有一定的临床意义。

Objective To explore the effect of montelukast on the treatment of airway inflammation in bronchiolitis after respiratory syncytial virus （RSV） infection by studying the clinical manifestations and changes of serum concentration of inflammatory cellular factors including eosinophil cationic protein （ECP）, interleukin-8 （IL-8）, and nitrogen monoxide （NO）. Methods 142 infants with bronchiolitis caused by primary infection of RSV associated with atopy （eczema, family asthmatic history） were recruited in the study and they were randomly divided into three groups after alleviation of asthmatic symptoms （group A was designated as oral intake of montelukast, group B as inhaled budesonide, and group C as blank control）. Blood samples were collected on the first day on admission, before treatment, 3 mouths after medication. Serum concentration of ECP, IL-8, and NO were measured. Follow up was done for one year. Statistical analysis was conducted with SPSS15.0 software package. Results The differences in patients with recurrence of asthma within 3 months and recurrence within one year between groups A and group C were significant, while the differences between group B and group C were not significant. The reduction of ECP and NO in group A were significant in comparison with group B. There was no statistical difference in serum level of IL-8 between group A and group B. Conclusions Montelukast might decrease the serum concentrations of ECP, NO, and IL-8 and it may play a role in the prevention of asthma.