孟鲁司特对毛细支气管炎患儿白三烯水平的影响
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摘要
目的观察孟鲁司特对毛细支气管炎患儿治疗前后血清白三烯B4及尿白三烯E4水平的影响。方法将2014年6~12月诊断为毛细支气管炎的患儿75例随机分为孟鲁司特治疗组(n=38)和对照组(n=37),两组患儿均进行常规综合治疗,治疗组在此基础上加用孟鲁司特片(4 mg),每晚1次,连续口服7 d;采用ELISA法检测两组治疗前后血清白三烯B4及尿白三烯E4水平,并进行临床疗效分析;采用Pearson分析对血清白三烯B4及尿白三烯E4水平进行相关性分析。结果治疗后两组患儿血清白三烯B4及尿白三烯E4水平比治疗前明显下降(P<0.05),且孟鲁司特治疗组血清白三烯B4及尿白三烯E4水平与对照组相比下降更为显著(P<0.05);孟鲁司特治疗组咳嗽、喘息、肺部喘鸣音缓解时间及住院时间均比对照组缩短(P<0.05);血清白三烯B4与尿白三烯E4水平存在正相关(r=0.723,P<0.05)。结论孟鲁司特治疗毛细支气管炎临床疗效确切,其作用机制与降低毛细支气管炎患儿血清白三烯B4及尿白三烯E4水平有关。
Objective To observe the effect of montelukast treatment on levels of serum leukotriene B4 and urinary leukotriene E4 in infants with bronchiolitis. Methods Seventy-five children who were diagnosed with bronchiolitis between June 2014 and December 2014 were randomly assigned into two groups, one with thirty-eight cases as the montelukast treatment group and another thirty-seven cases as the control group. All of the children were given routine medical treatment. The children in the montelukast treatment group were additionally given montelukast daily(4 mg once a day, for 7 days). The serum leukotriene B4 and urinary leukotriene E4 levels were measured using ELISA before and after treatment. The relationship between serum leukotriene B4 and urinary leukotriene E4 levels was analyzed by Peason correlation analysis. Results After 7 days of treatment, the serum leukotriene B4 and urinary leukotriene E4 levels in the montelukast treatment and control groups were significantly reduced compared with before treatment(P<0.05). The montelukast treatment group showed significantly lower serum leukotriene B4 and urinary leukotriene E4 levels than the control group(P<0.05). The remission time of cough, wheezing and lung wheezes and the length of hospital stay in the montelukast treatment group were significantly shortened compared with the control group(P<0.05). There was a positive correlation between serum leukotriene B4 and urinary leukotriene E4 levels(r=0.723, P<0.05). Conclusions Montelukast has a reliable clinical curative efficacy for bronchiolitis in infants, possibly by decreasing serum leukotriene D4 and urinary leukotriene E4 levels.
Objective To observe the effect of montelukast treatment on levels of serum leukotriene B4 and urinary leukotriene E4 in infants with bronchiolitis. Methods Seventy-five children who were diagnosed with bronchiolitis between June 2014 and December 2014 were randomly assigned into two groups, one with thirty-eight cases as the montelukast treatment group and another thirty-seven cases as the control group. All of the children were given routine medical treatment. The children in the montelukast treatment group were additionally given montelukast daily(4 mg once a day, for 7 days). The serum leukotriene B4 and urinary leukotriene E4 levels were measured using ELISA before and after treatment. The relationship between serum leukotriene B4 and urinary leukotriene E4 levels was analyzed by Peason correlation analysis. Results After 7 days of treatment, the serum leukotriene B4 and urinary leukotriene E4 levels in the montelukast treatment and control groups were significantly reduced compared with before treatment(P<0.05). The montelukast treatment group showed significantly lower serum leukotriene B4 and urinary leukotriene E4 levels than the control group(P<0.05). The remission time of cough, wheezing and lung wheezes and the length of hospital stay in the montelukast treatment group were significantly shortened compared with the control group(P<0.05). There was a positive correlation between serum leukotriene B4 and urinary leukotriene E4 levels(r=0.723, P<0.05). Conclusions Montelukast has a reliable clinical curative efficacy for bronchiolitis in infants, possibly by decreasing serum leukotriene D4 and urinary leukotriene E4 levels.
引文
[1]Bacharier LB.Viral-induced wheezing episodes in preschool children:approaches to therapy[J].Curr Opin Pulm Med,2010,16(1):31-35.
[2]何美娟,陈强,刘建梅.支气管哮喘儿童尿白三烯E4检测的临床意义[J].中国当代儿科杂志,2009,11(11):909-912.
[3]Da Dalt L,Callegaro S,Carraro S,et al.Nasal lavage leukotrienes in infants with RSV bronchiolitis[J].Pediatr Allergy Immunol,2007,18(2):100-104.
[4]Kim CK,Choi J,Kim HBJ,et al.A randomized intervention of montelukast for post-bronchiolitis:effect on eosinophil degranulation[J].J Pediatr,2010,156(5):749-754.
[5]王爱珍,张振宇,赵罗忠.呼吸道合胞病毒毛细支气管炎患儿尿白三烯E4水平变化及其临床意义[J].实用儿科临床杂志,2010,16(25):1241-1242.
[6]胡亚美,江载芳,诸福棠.实用儿科学[M].第7版.北京:人民卫生出版社,2002:1199-1201.
[7]中华医学会儿科学分会呼吸学组.毛细支气管炎诊断、治疗和预防专家共识(2014版)[J].中华儿科杂志,2015,53(3):168-171.
[8]田曼,施圣云,秦铭,等.儿童急性下呼吸道感染病毒病原学分析[J].临床儿科杂志,2010,28(2):120-123.
[9]Takemura M,Niimi A,Matsumoto H,et al.Clinical,physiological and anti-inflammatory effect of montelukast in patients with cough variant asthma[J].Respiration,2012,83(4):308-315.
[10]张满燕,何英,李琳,等.喘息患儿与呼吸道合胞病毒、肺炎支原体感染关系及尿白三烯E4测定的研究[J].中国医师杂志,2010,12(2):269-271.
[11]De Jongste JC.To wheeze or not to wheeze:Prospective FENOtyping in early infancy[J].Am J Respir Crit Care Med,2006,174(12):1281-1285.
[12]Montella S,Maglione M,Stefano SD,et al.Update on leukotriene receptor anta-gonists in preschool children wheezing disorders[J].Ita J Pediatr,2012,38:29.
[13]冯雪莉,申昆玲,熊珍谊,等.呼吸道合胞病毒毛细支气管炎42例白三烯致病作用研究[J].中国实用儿科杂志,2008,23(12):920-923.
[14]Kleinman R,Mura M,Liu MY.Cysteinyl leukotrienes antagonists as a treatment for children with asthma[J].中国当代儿科杂志,2005,7(5):398-403.
[15]陈秋芳,张海邻,余刚,等.呼吸道和胞病毒毛细支气管炎患儿炎症递质的变化[J].临床儿科杂志,2014,32(2):115-117.
[16]Zedan M,Gamil N,EI-Assmy M,et al.Montelukast as an episodic modifier for acute viral bronchiolitis:a randomized trial[J].Allergy Asthma Proc,2010,31(2):147-153.
[17]李莹,代继红,符州.孟鲁司特对呼吸道合胞病毒毛细支气管炎的治疗作用[J].实用儿科临床杂志,2011,26(10):798-800.
[18]王素梅,潘同国,刘萍,等.孟鲁司特对呼吸道合胞病毒毛细支气管炎患儿尿白三烯E4的影响[J].湖北医药学院学报,2011,30(5):514-516.
[19]姚欢银,刘淑梅,朱国政,等.毛细支气管炎患儿尿白三烯E4检测及其意义[J].临床儿科杂志,2010,28(2):152-155.
[2]何美娟,陈强,刘建梅.支气管哮喘儿童尿白三烯E4检测的临床意义[J].中国当代儿科杂志,2009,11(11):909-912.
[3]Da Dalt L,Callegaro S,Carraro S,et al.Nasal lavage leukotrienes in infants with RSV bronchiolitis[J].Pediatr Allergy Immunol,2007,18(2):100-104.
[4]Kim CK,Choi J,Kim HBJ,et al.A randomized intervention of montelukast for post-bronchiolitis:effect on eosinophil degranulation[J].J Pediatr,2010,156(5):749-754.
[5]王爱珍,张振宇,赵罗忠.呼吸道合胞病毒毛细支气管炎患儿尿白三烯E4水平变化及其临床意义[J].实用儿科临床杂志,2010,16(25):1241-1242.
[6]胡亚美,江载芳,诸福棠.实用儿科学[M].第7版.北京:人民卫生出版社,2002:1199-1201.
[7]中华医学会儿科学分会呼吸学组.毛细支气管炎诊断、治疗和预防专家共识(2014版)[J].中华儿科杂志,2015,53(3):168-171.
[8]田曼,施圣云,秦铭,等.儿童急性下呼吸道感染病毒病原学分析[J].临床儿科杂志,2010,28(2):120-123.
[9]Takemura M,Niimi A,Matsumoto H,et al.Clinical,physiological and anti-inflammatory effect of montelukast in patients with cough variant asthma[J].Respiration,2012,83(4):308-315.
[10]张满燕,何英,李琳,等.喘息患儿与呼吸道合胞病毒、肺炎支原体感染关系及尿白三烯E4测定的研究[J].中国医师杂志,2010,12(2):269-271.
[11]De Jongste JC.To wheeze or not to wheeze:Prospective FENOtyping in early infancy[J].Am J Respir Crit Care Med,2006,174(12):1281-1285.
[12]Montella S,Maglione M,Stefano SD,et al.Update on leukotriene receptor anta-gonists in preschool children wheezing disorders[J].Ita J Pediatr,2012,38:29.
[13]冯雪莉,申昆玲,熊珍谊,等.呼吸道合胞病毒毛细支气管炎42例白三烯致病作用研究[J].中国实用儿科杂志,2008,23(12):920-923.
[14]Kleinman R,Mura M,Liu MY.Cysteinyl leukotrienes antagonists as a treatment for children with asthma[J].中国当代儿科杂志,2005,7(5):398-403.
[15]陈秋芳,张海邻,余刚,等.呼吸道和胞病毒毛细支气管炎患儿炎症递质的变化[J].临床儿科杂志,2014,32(2):115-117.
[16]Zedan M,Gamil N,EI-Assmy M,et al.Montelukast as an episodic modifier for acute viral bronchiolitis:a randomized trial[J].Allergy Asthma Proc,2010,31(2):147-153.
[17]李莹,代继红,符州.孟鲁司特对呼吸道合胞病毒毛细支气管炎的治疗作用[J].实用儿科临床杂志,2011,26(10):798-800.
[18]王素梅,潘同国,刘萍,等.孟鲁司特对呼吸道合胞病毒毛细支气管炎患儿尿白三烯E4的影响[J].湖北医药学院学报,2011,30(5):514-516.
[19]姚欢银,刘淑梅,朱国政,等.毛细支气管炎患儿尿白三烯E4检测及其意义[J].临床儿科杂志,2010,28(2):152-155.