孟鲁司特联合布地奈德对缓解期小儿哮喘气道反应性及哮喘控制的影响

Effects of montelukast combined with budesonide on airway responsiveness and asthma control in children with asthma in remission stage

目的探讨孟鲁司特联合布地奈德对缓解期小儿哮喘气道反应性及哮喘控制的影响。方法选择阳江市阳江妇幼保健院儿科于2015年10月至2017年10月期间收治的110例哮喘患儿为研究对象,根据随机数表法分为观察组与对照组,每组55例,对照组予吸入布地奈德治疗,观察组则在此基础上联合应用孟鲁司特治疗,疗程均为6个月。比较两组患儿治疗后诱导痰中炎性细胞计数,治疗前后肺功能指标第1秒肺活量(FEVl)、呼气峰流速(PEF)的变化。治疗结束后随访1年,记录呼吸道感染及哮喘发作情况。结果治疗后,观察组患儿诱导痰中性粒及嗜酸性粒细胞百分比分别为(44.54±4.62)%、(7.86±1.56)%,明显低于对照组的(49.72±4.72)%、(12.41±2.14)%,淋巴细胞百分比为(42.37±4.72)%,明显高于对照组的(37.62±3.56)%,差异均有统计学意义(P<0.05);治疗后,观察组患儿的FEV1、PEF分别为(1.53±0.28) L、(3.31±0.60) L/s,明显高于对照组的(1.41±0.22) L、(2.84±0.51) L/s,差异均具有统计学意义(P<0.05);随访1年时,观察组患儿上、下呼吸道感染及哮喘发作次数分别为(2.27±0.54)次、(1.32±0.45)次、(2.83±0.72)次,明显低于对照组的(2.89±0.75)次、(1.67±0.53)次、(3.42±0.91)次,差异均有统计学意义(P<0.05)。结论小儿哮喘缓解期应用孟鲁司特联合布地奈德治疗可以有效降低气道高反应性、控制哮喘发作。

Objective To investigate the effects of montelukast combined with budesonide on airway responsiveness and asthma control in children with asthma in remission stage. Methods A total of 110 children with asthma,who treated in Pediatrics Department of Yangjiang Maternal and Child Health Hospital from October 2015 to October2017, were selected and divided into the observation group and the control group according to random number table method, with 55 cases in each group. The control group was treated with budesonide inhalation, while the observation group was treated with montelukast on this basis. The course of treatment was 6 months. Inflammatory cell counts in induced sputum, vital capacity(FEVl), and peak expiratory flow(PEF) were compared between the two groups. The children were followed up for one year after the treatment. The respiratory tract infection and asthma attack were recorded.Results After treatment, the percentages of induced sputum neutrophils, and eosinophils in the observation group were(44.54 ± 4.62)%,(7.86 ± 1.56)%, respectively, which was significantly lower than corresponding(49.72 ± 4.72)% and(12.41±2.14)% of the control group(P<0.05). The percentage of lymphocyte was(42.37±4.72)%, which was significantly higher than(37.62±3.56)% of the control group(P<0.05). After treatment, FEV1 and PEF in the observation group were(1.53±0.28) L and(3.31±0.60) L/s, respectively, significantly higher than(1.41±0.22) L and(2.84±0.51) L/s in the control group(P<0.05). During a follow-up period of one year, the number of episodes of upper and lower respiratory tract infection and asthma in the observation group were(2.27±0.54),(1.32±0.45) and(2.83±0.72), respectively, which was significantly lower than corresponding(2.89±0.75),(1.67±0.53),(3.42±0.91) in the control group(P<0.05). Conclusion The combination of montelukast and budesonide can effectively reduce airway hyperresponsiveness, and control asthma attack in asthmatic children during the remission stage.