布地奈德联合孟鲁司特防治RSV下呼吸道感染疗效与后续喘息的研究

The efficacy and follow up study of Budesonide combined with Montelukast in the treatment of acute RSV-lower respiratory tract infection

目的了解吸入激素联合孟鲁司特对急性期呼吸道合胞病毒(RSV)下呼吸道感染(RSV-LTRI)的疗效作用及对后续喘息和哮喘的预防作用。方法采用回顾性研究,采用单一RSV-Ig M阳性患儿作病例回顾及随访分析。结果纳入65例患儿,按治疗方式分为吸入激素组(ICS组),吸入激素联合孟鲁司特组(I+M组)及对照组。RSV-LTRI患儿肺部出现喘鸣音表现者ICS组及I+M明显多于对照组,差异有统计学意义(P均<0.05)。C反应蛋白较正常值偏高,对照组患儿CRP明显增高,与ICS组及I+M组比较差异有统计学意义(P均<0.05)。ICS组需使用激素人次最多,与对照组比较差异有统计学意义(P<0.05)。三组患儿肺部平均啰音消失以I+M组啰音消失最早,与ICS组及对照组差异有统计学意义(P<0.05)。三组间在与哮喘和反复喘息发生的关系上差异无统计学意义。结论 RSV-LTRI能导致急性喘息及后续的喘息和哮喘,ICS及白三烯拮抗剂联合应用可有助减轻急性感染期患儿喘息症状,但不能有效预防后续的喘息和哮喘发生。

Objective To investigate ICS combined with montelukast on acute RSV infection of the lower respiratory tract （RSV-LTRI）, and the preventive effect on subsequent wheezing and asthma. Methods Children with single RSV-IgM positive were analyzed with retrospective study and follow-up. Results 65 children were included in the study, and divided into ICS group, ICS combined with montelukast group （ I ＋ M group） and the control group. Children with young age were infected by RSV, and the percentage of wheezing symptoms in ICS group and I ＋ M group was higher than that of control. C reaction protein in the control group was markedly increased. Most children need to use corticosteroids in ICS group, there was different in ICS group compared with control group. It had statistical significance （P 〈 0. 05） . The wheezes in the lung in the I ＋ M group was disappeared in the earliest. No statistical significance between the three groups in the relationship of the occurrence of asthma and recurrent wheezing. Conculusion RSV-LTRI can lead to acute wheezing and subsequent wheezing and asthma, ICS com- bined with montelukast could held alleviate the acute asthmatic svmPtoms, but can not nrevent subseauent wheezine and asthma.