丙酸氟替卡松气雾剂和孟鲁司特钠对毛细支气管炎后喘息反复发作干预效果观察

The effect of leukotriene antagonists and inhaled glucocorticoid on the treatment of recurrent wheezing after bronchiolitis

目的比较口服白三烯受体拮抗剂、吸入糖皮质激素对毛细支气管炎(简称:毛支炎)后喘息反复发作的疗效。方法选择初次毛支炎治愈后患儿78例,将患者随机分为三组,A组26例口服孟鲁司特钠,B组28例吸入丙酸氟替卡松气雾剂,疗程均为12周,C组24例未给予治疗,随访观察2年,了解两种干预治疗对患儿反复喘息发作的影响。结果 C、B、A三组患者毛支炎后喘息再发时间依次延长,喘息再发次数及进展成哮喘的例数依次减少,差异有统计学意义(P<0.05),三组喘息再发率差异无统计学意义(P>0.05),B组与C组2年内进展成哮喘的比例差异无统计学意义(α'=0.017,P<0.017)。结论两种干预方法不能减少毛支炎后喘息的再发,但可以延长再发时间、减少发作次数,白三烯受体拮抗剂降低毛支炎后哮喘发生率的效果优于吸入糖皮质激素。

Objective To compare the effect of leukotriene antagonists and inhaled glucocorticoid on bronchiolitis.Methods 78 infants recovered from first bronchiolitis were randomly divided into three groups. Group A（ n = 26） was designated as oral intake of montelukast,and group B（ n = 28） as inhaled fluticasone propionate,for 12 weeks. Group C（ n = 24） had no treatment as blank control. These bronchiolitis children were followed up another two years without special medication in order to observe the interventional effect on wheezing post-bronchiolitis by intervention treatment. Results In the following order： C,B,A,recurrence intervening time of wheezing post-bronchiolitis was prolonged,recurrence frequency of wheezing post-bronchiolitis was decrease,and the difference between the groups was statistically significant（ P〈 0. 05）,but the recurrence of wheezing post-bronchiolitis in the three groups had no significant differences,and the progress of asthma ratio in 2 years in group B and group C had no significant differences. Conclusions Oral intake of leukotriene antagonists or inhaled glucocorticoid can not decrease the risk of wheezing post- bmnchiolitis,but both can prolong recurrence intervening time and decrease recurrence frequency,the leukotriene antagonists has superior effect in reducing incidence of asthma after bronchiolitis than inhaled glucocorticoid.