白三烯受体拮抗剂联合糠酸莫米松鼻喷剂对腺样体肥大患儿睡眠质量及呼吸功能影响研究

Effect of leukotriene receptor antagonist and mometasone furoate nasal spray on sleep quality and respiratory function in children with adenoid hypertrophy

目的:探讨白三烯抗体拮抗剂孟鲁斯特联合糖皮质激素类药物糠酸莫米松鼻喷剂在改善腺样体肥大(AH)患儿睡眠质量及呼吸功能方面的作用。方法:将63例AH患儿分为两组,对照组仅接受糖皮质激素类药物糠酸莫米松鼻喷剂治疗,观察组在对照组治疗基础上每晚口服白三烯抗体拮抗剂。对比两组患儿治疗前后不同时间点血清变态反应指标(sIgE、ECP及EOS)及治疗前后睡眠障碍评分、张口呼吸评分及腺样体/鼻咽(A/N)改善情况。结果:随着药物治疗时间延长,两组患儿变态反应指标sIgE、ECP及EOS值均持续下降,且观察组患儿指标下降程度均明显优于对照组(P<0.05)。经治疗,两组患儿睡眠障碍及张口呼吸评分均明显下降,且观察组睡眠障碍及张口呼吸评分明显低于对照组,A/N值明显低于治疗前(P<0.05);而对照组A/N值下降不明显,与治疗前比,差异无统计学意义(P>0.05)。结论:白三烯抗体拮抗剂孟鲁斯特联合糖皮质激素类药物可有效缩小AH患儿腺样体体积,降低变态反应程度,改善患儿睡眠质量及呼吸状况。

Objective:To investigate the effect of levoterine antibody antagonist montelukast combined with glucocorticoid mometasone nasal spray on improving sleep quality and respiratory function in children with adenoid hypertrophy(AH).Methods:63 cases of AH children were divided into two groups,the control group received only glucocorticoid mometasone furoate nasal spray treatment,the observation group in the control group on the basis of the treatment of oral administration of leukotriene antibody antagonists.Serum allergic reaction indexes(sIgE,ECP and EOS)and sleep disturbance scores before and after treatment were compared between two groups before and after treatment.The respiratory scores of mouth and A/N of A/N were compared.Results:The sIgE,ECP and EOS values of two groups of children decreased continuously with the prolongation of drug treatment,and the indexes of children in the observation group were significantly lower than those of the control group(P<0.05).After treatment,sleep disorders and mouth breathing scores of both groups were significantly decreased,and sleep disturbance and mouth breathing scores of the observation group were significantly lower than those of the control group,A/N values were significantly lower than those before treatment(P<0.05)There was no significant difference in A/N value between before and after treatment(P>0.05).Conclusion:Leukotriene antagonist combined with glucocorticoid can effectively reduce the adenoid volume,reduce the degree of allergic reaction and improve the sleep quality and respiratory status in children with AH.