两种方法治疗婴幼儿病毒感染性疾病并发喘息的临床评价

Clinical evaluation of wheezing infants with viral infections

目的比较两种方法治疗婴幼儿病毒感染性疾病并发喘息的临床效果。方法90例病毒检出阳性的喘息患儿根据治疗方法的不同分观察组50例和对照组40例，对照组患儿给予常规治疗＋糖皮质激素雾化吸入，观察组在对照组治疗基础上口服孟鲁司特，4mg／次，每晚顿服，连用10d。观察两组患儿的临床疗效、症状体征改善情况、肺功能、血气分析的变化和不良反应。结果初次喘息病毒阳性70例（77．7％），明显高于反复喘息病毒阳性20例（22．2％）（X^2=6．65，P〈0．01）；两组治疗后Pa02较治疗前改善明显（t=2．542、2．533，均P〈0．05）；观察组总有效率为88．0％，明显高于对照组的72．5％（X^2=3．751，P〈0．05）；观察组不良反应发生率4．0％（2／50），明显低于对照组的10．0（4／40）（x^2=3．857，P〈0．05）。结论孟鲁司特治疗婴幼儿病毒感染性疾病并发喘息的疗效确切，不良反应少。

Objective To investigate the clinical effects of montelukes in treatement of wheezing infants with viral infections. Methods 90 wheezing infants with viral infections were divided into oral Montelukas treatment（ Group A） 50 cases and inhaled corticosteroid treatment （Group B ） 40 cases, Group B were treated with conventional therapy plus glucocorticoids,Group A in addition to therapy with Montelukast 4mg/time at a draught quaque nocte for 10 days. The clinical effect,improvement of symptoms,pulmonary function, blood gas analysis and the side effects were observed for the infants in both groups. Results The viral infections-positive with first break in 70 cases （77.7%） were significantly higher than that recurrent break in 20 cases （22.2%） （ X^2 = 6.65, P 〈 0.01 ） ; The scores of PaO2 after treatment were significantly higher than before treatment in two groups（ t = 2. 542,2. 533, all P 〈 0.05 ） ; A total effective rate was 88.0% in group A which was significantly higher than that 72.5% in group B（ X^2 = 3. 751 ,P 〈 0. 05） ;The adverse reactions incidence 4.0% （2/50） in group A was significantly lower than the B group 10.0% （4/40） in group B （X^2 = 3. 857 ,P 〈 0.05 ）. Conclusion Montelukast had definitely effect for infant wheezing with virus infection, and had less side effects.