孟鲁司特治疗儿童支原体肺炎致慢性咳嗽的疗效观察

An investigation of therapeutic effect of Montelukast on mycoplasma pneumonia induced chronic cough inchildren

目的观察孟鲁司特治疗儿童支原体感染致慢性咳嗽的临床疗效。方法选择本院收治的支原体感染后慢性咳嗽的患儿60例，按随机原则分为对照组和治疗组，每组30例。两组均采用相同的止咳化痰药对症处理。治疗组同时加用孟鲁司特（顺尔宁）睡前口服，每次1片（〈6岁用每片4mg，≥6岁用每片5mg），每日1次，连续服用4周。于治疗后1、2、3、4周观察咳嗽缓解情况；于治疗后4周取静脉血，采用双抗体夹心酶联免疫吸附试验（ELISA）检测嗜酸粒细胞阳离子蛋白（ECP）和白细胞介素-5（IL-5）水平。结果随着治疗时间的延长，两组咳嗽缓解率均不断增加，且治疗组缓解率明显高于对照组（1周：60．0％比20．0％，2周：83．3％比33．3％，3周：90．0％比53．3％，4周：93．3％比66．7％，均P〈0．05）。治疗4周后，两组ECP水平均明显降低（均P〈0．05），但治疗组治疗后ECP（-L）水平与对照组比较差异无统计学意义（4．62±1．53比4．03±1．12，P〉0．05）；对照组IL-5（ng／L）水平无明显变化（P〉0．05），治疗组明显下降，且治疗组下降程度较对照组更显著（42．24±9．44比61．89±11．67，P〈0．05）。结论孟鲁司特治疗儿童支原体感染后慢性咳嗽能降低气道炎症，缓解咳嗽症状，缩短病程，疗效肯定，值得临床推广。

Objective To investigate the effect of Montelukast on mycoplasma infection induced chronic cough in children. Methods Sixty children with chronic cough after mycoplasma infection were recruited in the study and were randomly divided into control group （30 cases） and treated group （30 cases）. Both groups received the same drugs to relieve cough and sputum. Montelukast was exclusively added in the treated group, once a pill/day, the dosage being a 4 mg pill for 〈6 years and a 5 mg one for ≥ 6 years children. The treatment lasted for 4 weeks. Cough symptom relief was observed 1, 2, 3 and 4 weeks after treatment. The eosinophil cationic protein （ECP） and interleukin-5 （IL-5）levels in venous blood were also determined by enzyme-linked immunosorbent assay （ELISA） 4 weeks after treatment. Results With the prolongation of treatment time, cough symptoms were gradually relieved in both groups, and the relief rates were higher in treated group than those in control group （ 1 week ： 60.0% vs. 20.0%, 2 weeks： 83.3% vs. 33.3%, 3 weeks ： 90.0% vs. 53.3%, 4 weeks ： 93.3% vs. 66.7%, all P〈0.05） . The ECP （pg/L）level in both groups was reduced obviously after 4 weeks （both P〈 0.05 ） ; the difference in the level after treatment between treated group and control group had no statistic significance （4.62 ± 1.53 vs. 4.03 ± 1.12, P 〉0.05 ）. The IL-5 （ng/L）level was reduced significantly in treated group （P〈0.05）, but there was no observable change in control group （P〉0.05）, the difference between the two groups being significant （42.24 ± 9.44 vs. 61.89 ± 11.67, P〈 0.05）. Conclusions Montelukast can significantly reduce bronchial inflammation, relieve the cough symptom, and shorten the course of the chronic cough induced by mycoplasma infection in children. Since its therapeutic effect is confirmed, it is worthwhile to be widely used in clinical practice.