白三烯受体拮抗剂防治婴幼儿喘息性疾病的临床观察

The effect observation of leukotriene receptor antagonists on prevention and treatment of asthmatic diseases in infants

目的探讨白三烯受体拮抗剂对婴幼儿喘息性疾病的治疗与预防作用。方法观察了2012年1月至2013年12月间我科住院诊治的85例：7个月-3岁以下婴幼儿喘息性疾病的患儿,应用随机数字表法分为观察组41例,对照组44例。分别采用以下治疗方法：对照组应用布地奈德混悬液1 mg/次,0.5%沙丁胺醇0.4 ml/次,0.025%爱全乐溶液1.25 ml/次,雾化吸入,每日二次;观察组：在对照组治疗的基础上加用白三烯受体拮抗剂（孟鲁司特钠咀嚼片）,剂量：2岁以上4 mg/次,2岁以下2 mg/次,每晚口服一次。两组患儿的护理、对症等基础治疗相同。疗程：对照组：临床症状体征缓解出院后不予治疗;治疗组：临床症状体征缓解出院后,继续服用孟鲁司特钠至总疗程6周。观察指标：观察两组病儿治疗前及治疗后72小时时,临床症状和体征的临床量化评分结果、观察两组喘憋缓解时间、喘鸣音消失时间、住院时间、出院后4周内、12周内喘息再次发作（指喘息发作停止1周以上再次发作者）人次。结果临床评分结果：两组治疗前评分结果进行组间比较,差异无统计学意义（P〉0.05）;两组各自治疗前后临床评分结果进行统计学处理,差异均具有显著性,具有统计学意义（P〈0.001）;而两组治疗后72 h评分结果进行组间比较,差异具有显著性,具有统计学意义（P〈0.001）。两组喘憋缓解时间比较,差异具有统计学意义（P〈0.05）;喘鸣音消失时间及住院时间比较,差异均具有统计学意义（P〈0.001）。两组病儿出院后4周内、12周内再次喘息发作人次比较差异也均具有统计学意义（P〈0.05）。结论白三烯受体拮抗剂防治小年龄段内的婴幼儿喘息性疾病疗效显著、安全、依从性好,值得在临床推广应用。

Objective Explore the effect of leukotriene receptor antagonist( LTRA) montelukast on prevention and treatment of asthmatic diseases in infants. Methods 85 cases,including infants aged from 7months to 3 years old and with asthmatic diseases and hospitalized in our hospital between January 2012 and December 2013,were randomly divided into two groups: 44 cases in control groupand 41 cases in LTRA- treated group. Kids in control group were treated with budesonide suspension liquid 1 mg / time,0. 5% salbutamol 0. 4ml / time and 0. 025% Ipratropium bromide solution 1. 25 ml / time,atomization inhalation,2 times / day. Infants in LTRA- treated group were treated with montelukast( montelukast sodium chewable tablet) once every night,at a dosage of 2 mg / time for infants < 2 years old and 4 mg / time for infants > 2 years by oral administration,and the other treatment and nursing wereas the same as control group. Since the symptoms were relieved and patients released from hospital,treatment were terminated,however patients the LTRA- treated group were continued to take montelukast to the end of six weeks after released from the hospital. Clinical signs and symptoms,the wheeze relieving and disappearing time,hospitalized length,wheeze relapse times within 4 weeks or 12 weeks after released from the hospital were monitored and quantified. Results There was no significant difference in clinical scores between the two groups before treatment( P > 0. 05). Statistically significant differences( P < 0. 001) were observed in clinical outcomes in both groups. 72 hours after treatment,the clinical outcomes of the two groups had a significant difference( P < 0. 001). The wheeze relieving and disappearing time,hospitalized length and wheeze relapse times within 4 weeks or 12 weeks after released from the hospital of the two groups were statistically significant( P < 0. 05). Conclusions The LTRA montelukast is an effective and safe drug for preventing and treating infant asthmatic disease.