孟鲁司特钠辅助治疗支原体肺炎合并哮喘急性发作患儿的效果研究

Study on the Effect of Montelukast Sodium in the Adjuvant Treatment of Children with Acute Attack of Mycoplasma Pneumonia and Asthma

目的探讨孟鲁司特钠辅助治疗支原体肺炎合并哮喘急性发作患儿的临床效果。方法选取2018年10月—2019年10月我院接受治疗的90例支原体肺炎合并哮喘急性发作患儿,根据治疗方法的不同分为观察组和对照组各45例。在基础治疗外,对照组患儿采用阿奇霉素联合酮替芬治疗,观察组患儿采用阿奇霉素联合孟鲁司特钠治疗。治疗7 d后,比较2组患儿临床疗效,治疗前后气道细胞因子水平和小气道功能情况,并记录治疗后90 d内不良反应发生情况。结果治疗后观察组患儿总有效率显著高于对照组患儿(P<0.05)。治疗后,2组患儿基质金属蛋白酶9(MMP9)较治疗前显著下降,组织基质金属蛋白酶抑制剂-1(TIMP-1)较治疗前显著升高,且观察组患儿MMP9下降及TIMP-1升高程度均高于对照组患儿,差异有统计学意义(P<0.05或P<0.01)。治疗后,2组患儿用力呼气25%、50%、75%肺活量瞬时流速占预计值百分比(FEF25%、FEF50%、FEF75%)较治疗前显著升高,且观察组患儿FEF25%、FEF50%、FEF75%升高程度大于对照组患儿,差异有统计学意义(P<0.05或P<0.01)。观察组患儿总不良反应发生率显著低于对照组患儿,差异有统计学意义(P<0.01)。结论在常规抗感染治疗基础上,联合应用孟鲁司特钠能有效提高支原体肺炎合并哮喘急性发作患儿临床疗效,减轻气道炎症反应,改善小气道功能,且不良反应较少。

Objective To investigate the clinical effect of montelukast sodium in the adjuvant treatment of children with acute attack of mycoplasma pneumonia complicated with asthma.Methods A total of 90 children with acute attack of mycoplasma pneumonia complicated with asthma admitted to our hospital from October 2018 to October 2019 were selected and divided into observation group(n=45)and control group(n=45)according to different treatment methods.In addition to basic treatment,the control group was treated with azithromycin combined with ketotifen,and the observation group was treated with azithromycin combined with montelukast sodium.At 7 d after treatment,the clinical efficacy,cytokine levels in the airway and small airway function of the two groups before and after treatment were compared,and the occurrence of adverse reactions within 90 d after treatment was recorded.Results After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the levels of matrix metalloproteinase9(MMP9)was significantly lower,and tissue inhibitor of metalloproteinase-1(TIMP-1)in the two groups were significantly higher than those before treatment;the decrease in MMP9 and the increase in TIMP-1 in the observation group were greater than those in the control group(P<0.05 or P<0.01).After treatment,the percentage of 25%,50%,75%forced expiratory flow to the predicted value(FEF25%,FEF50%,FEF75%)of the instantaneous flow rate of vital capacity in the two groups was significantly higher than that before treatment,and the increase of FEF25%,FEF50%,FEF75%in the observation group was greater than that in the control group(P<0.05 or P<0.01).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.01).Conclusion On the basis of conventional anti infection treatment,combination treatment with montelukast sodium can effectively improve the clinical efficacy of children with acute attack of mycoplasma pneumonia complicated with asthma,reduce airway inflammatory reaction,improve small airway function,and has fewer adverse reactions.