孟鲁司特对呼吸道合胞病毒毛细支气管炎患儿血清半胱氨酰白三烯水平的影响及疗效观察

The effect of Montelukast on serum cysteinyl leukotrenes(CysLTs) of respiratory syncytial virus(RSV) bronchiolitis in children and curative effect

目的探讨孟鲁司特对呼吸道合胞病毒毛细支气管炎(RSV)患儿血清半胱氨酰白三烯(CysLTs)水平的影响及疗效。方法选取84例RSV毛细支气管炎患儿,随机分为观察组和对照组。两组患儿均予以抗病毒、解痉平喘和止咳化痰等对症治疗。观察组患儿加用孟鲁司特咀嚼片2 mg,睡前口服,连用8周。结果治疗1周后,两组患儿血清CysLTs水平均较治疗前明显下降(P<0.05或P<0.01),且观察组患儿下降幅度明显高于对照组(P<0.05);观察组患儿临床总有效率明显高于对照组(χ2=4.46,P<0.05);两组患儿均未发生明显药物不良反应;观察组患儿随访半年和1年内的喘息复发率均明显低于对照组(χ2=4.54和5.59,P均<0.05)。结论孟鲁司特治疗RSV毛细支气管炎疗效确切,安全性较好,并能减少喘息复发率,作用与其能降低血清CysLTs水平、减少白三烯的释放密切相关。

Objective To discuss the effect of Montelukast on serum cysteinyl leukotrenes（CysLTs） of Respiratory Syn cytial Virus （RSV） bronchiolitis in children. Methods A total of 84 cases of children with RSV bronchiolitis were se lected and divided into observation group and control group at random. The children in two groups were given symptomatic treatment, such like antiirus, spasmolysis and relieving asthma, relieving cough and reducing sputum and etc, which shall be stopped until the symptom disappeared. The children in observation group were additionally given 2 mg Montelukast Dulcet, and taken through the mouth at bedtime for 8 weeks. Results After 1 week＇s medical treatment, the serum CysLTs levels of children in two groups declined obviously than before（P〈0.05 or P〈0.01）, and the declining rate in experimental group was much higher than that in control group （P〈0.05）, and the total clinical efficiency of children in observation group was much higher than that in control group （X2=4.46, P〈0.05）. No obvious drug adverse reaction were appeared in children in two groups during the medical treatment. According to the following-up after the medical treatment, the gasping reoccurrence of children in observation group within half a year and one year were much lower than those in control group （X2=4.54 ＆ 5.59, P all〈0.05）. Conclusion Montelukast has reliable curative effect on RVS bronchiolitis with high security, and can reduce the gasping rate, whose mechanism of action has close relationship with the descreaded of serum serum CysLTs levels and the reduction of the release of Leukotriene.