孟鲁司特联合布地奈德对哮喘急性发作患儿炎性因子和肺功能的影响

Effects of Montelukast combined with Budesonide on inflammatory factors and pulmonary function in children with acute asthmatic attack

目的研究孟鲁司特联合布地奈德对哮喘急性发作患儿炎性因子和肺功能的影响。方法将2014年6月至2016年6月本院收治的哮喘急性发作患儿114例按照随机数表法分为联合组和对照组,每组各57例。对照组患儿均采取基础治疗联合布地奈德雾化吸入治疗,联合组患儿在对照组治疗基础上口服孟鲁司特,治疗7天后评价两组患儿的疗效。结果治疗后,两组患儿白介素(interleukin,IL)-4、IL-8、IL-13及白三烯B4(leukotriene B4,LTB4)水平均明显低于治疗前(P<0.01),且联合组患儿IL-8和LTB4水平均明显低于对照组(P<0.01)。治疗后,两组患儿第一秒用力呼气量(forced expiratory volume in first second,FEV_1)、用力肺活量(forced vital capacity,FVC)、第一秒用力呼气量占用力肺活量百分率(FEV_1/FVC)及呼气流量峰值(peak expiratory flow,PEF)均显著高于治疗前(P<0.01),而联合组患儿上述指标水平均高于对照组(P<0.05)。联合组患儿呼吸困难、咳嗽、喘息及哮鸣音持续时间均明显短于对照组(P<0.05)。结论孟鲁司特联合布地奈德可有效降低小儿哮喘急性发作时的炎性因子水平,改善患儿通气功能,缩短哮喘持续时间。

Objective To explore the effects of Montelukast combined with Budesonide on inflammatory factors and pulmonary function in children with acute asthmatic attack. Method 114 children with acute asthmatic attack from June 2014 to June 2016 in our hospital were randomly divided into combined group and control group according to the random number table method, 57 cases in each group. Control group children were treated with Budesonide inhalation therapy combined with basic treatment, combined group children were treated with Montelukast on the basis of control group. 7 days after treatment, the efficacy of the two groups was evaluated. Result After treatment, the levels of interleukin （IL） -4, IL-8, IL-13 and leukotriene B4 （LTB4） of the two groups were significantly lower than those of before treatment （P 〈 0.01）, the levels of IL-8 and LTB4 in combined group were significantly lower than those in control group （P 〈 0.01）. After treatment, forced expiratory volume in first second （FEV1）, forced vital capacity （FVC）, FEV1/FVC and peak expiratory flow （PEF） of the two groups were significantly higher than those of before treatment （P 〈 0.01）. The levels of above indexes in combined group were higher than those in control group （P〈0.05）. The duration of dyspnea, cough, gasping and wheezing in combined group were significantly shorter than those in control group （P 〈 0.05）. Conclusion Montelukast combined with Budesonide can effectively reduce the levels of inflammatory factors in children with acute asthmatic attack, improve pulmonary function, shorten the duration of asthma.