孟鲁司特钠联合阿奇霉素对哮喘合并肺炎支原体感染患儿肺功能及炎症反应的影响

Effect of Montelukast Sodium Combined with Azithromycin on Pulmonary Function and Inflammatory Response in Children with Asthma and Mycoplasma Pneumoniae Infection

目的:观察孟鲁司特钠联合阿奇霉素对哮喘合并肺炎支原体(MP)感染患儿肺功能及炎症反应的影响,旨在指导未来哮喘合并MP感染患儿的临床治疗,以期提高患儿获益。方法:选择2016年1月~2017年12月本院符合条件的105例哮喘合并MP感染患儿作为研究对象,按1~105为患儿编号,奇数号纳入对照组,偶数号纳入观察组。在常规综合治疗基础上,对照组采用阿奇霉素治疗,观察组采用孟鲁司特钠联合阿奇霉素治疗,两组均持续治疗3周。对比两组治疗前1天、治疗3周时肺功能[第1秒用力呼气容积占预测值的比值(FEV 1%)、用力肺活量占预测值的比值(FVC%)]与炎症反应[嗜酸性粒细胞(EOS)、C反应蛋白(CRP)]改善情况;对比两组治疗期间不良反应(恶心、呕吐、腹泻、腹痛等)发生率。结果:治疗3周时,两组患儿FEV 1%、FVC%较治疗前1天升高,且观察组高于对照组,有统计学差异(P<0.05);治疗3周时,两组患儿EOS、CRP水平较治疗前1天降低,且观察组低于对照组,有统计学差异(P<0.05);治疗期间,两组各不良反应发生率无统计学差异(P>0.05)。结论:孟鲁司特钠联合阿奇霉素能有效改善哮喘合并MP感染患儿的肺功能、减轻患儿气道炎症反应,联合用药期间不良反应未增加,安全性高,临床应用价值高,值得推广。

Objective:To observe the effect of montelukast sodium combined with azithromycin on pulmonary function and inflammatory response in children with asthma and mycoplasma pneumoniae(MP)infection,so as to guide the clinical treatment of children with asthma and MP infection,and to increase the benefits of children.Methods:105 children with asthma and MP infection in the hospital from January 2016 to December 2017 were selected as the research subjects.The children were numbered from 1 to 105,odd numbers were included in the control group,and even numbers were included in the observation group.On the basis of conventional comprehensive treatment,control group was treated with azithromycin,and observation group was treated with montelukast sodium combined with azithromycin,for 3 consecutive weeks.The pulmonary function[the ratio of the forced expiratory volume in the first second to the predicted value(FEV 1%),the ratio of the forced vital capacity to the predicted value(FVC%)]and inflammatory response[eosinophil(EOS),C-reactive protein(CRP)]were compared between two groups at 1 day before treatment and 3 weeks after treatment;The incidence of adverse reactions(nausea,vomiting,diarrhea,abdominal pain)during treatment was compared between the two groups.Results:The levels of FEV 1 and FVC%in two groups after treatment for 3 weeks were higher than those at 1 day before treatment,and results in the observation group was higher than control group(P<0.05);The levels of EOS and CRP in two groups after treatment for 3 weeks were lower than those at 1 day before treatment,and was lower in the observation group than in the control group(P<0.05);There was no statistical difference in the incidence of adverse reactions between two groups during treatment(P>0.05).Conclusion:Montelukast sodium combined with azithromycin in children with asthma and MP infection can improve pulmonary function,alleviate airway inflammatory response without increase adverse reactions during treatment,and have high medication safety,which has high clinical application value and is worthy of promotion.