孟鲁司特治疗婴幼儿喘息的疗效及与机体变应性的关系

Relevance analysis of montelukast on the efficacy of infant wheezing and organic allergy

目的:探讨孟鲁司特在婴幼儿喘息中的疗效与过敏原及总IgE(TIgE)的关系。方法:选择反复喘息的婴幼儿60例,口服孟鲁司特4mg,每晚1次,疗程12周,停药后再观察12周,用药前作血TIgE、常见吸入过敏原和食物过敏原筛查。结果:孟鲁司特的治疗有效率为83%,疗效明显的患儿中食物过敏原阳性率(77.1%)明显高于吸入过敏原阳性率(33.3%),疗效欠佳的患儿食物过敏与吸入过敏原阳性率无明显差异。治疗效果与食物过敏原阳性存在相关性(P<0.05),与吸入过敏原阳性、吸入+食物过敏原阳性和TIgE升高无明显相关性(P>0.05)。结论:孟鲁司特对反复喘息的发作有控制和预防作用;过敏原阳性及TIgE升高可能是婴幼儿反复喘息发生的重要危险因素,孟鲁司特的治疗效果与食物过敏原阳性存在相关性。

Objective To investigate the relationship between Montelukast efficacy on infant wheezing and allergen, total IgE.Methods Sixty infants of recurrent wheezing were enrolled, given oral Montelukast 4 mg at night for 12 weeks, observed for 12 weeks after drug withdrawal.Serum total IgE, common inhaled allergens and food allergens were tested before treatment.Results The efficacy of Montelukast was 83% .Food-allergens positive rate（77.1%） was significantly higher than inhaled-allergen positive rate（33.3% ） in children with apparent efficacy（P 0.01）.There was no significant difference between food allergen-positive rate and inhaled allergen-positive rate in poor efficacy children.There was a significant correlation between the efficacy and food allergen-positive（P 0.05）.There was no significant correlation among the inhaled allergen-positive, inhaled allergen-positive ＋ food allergen-positive and higher total IgE（P 0.05）.Conclusions Montelukast may play a role in controling and preventing recurrent wheezing.Allergen-positive rate and higher total IgE level may be the important risk factors in recurrent wheezing infants.There was a significant correlation between the efficacy and food allergen-positive rate.