孟鲁司特钠治疗儿童呼吸道合胞病毒感染毛细支气管炎的疗效及其对炎症因子的影响
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摘要
目的:探讨孟鲁司特钠治疗呼吸道合胞病毒(RSV)感染的毛细支气管炎患儿的疗效及对其炎症因子水平的影响。方法:选取2016年3月至2017年4月我院儿科收治的RSV感染的毛细支管炎患儿154例,采用随机数表法分为对照组和观察组各77例,对照组给予常规治疗,观察组在常规治疗基础上加用孟鲁司特钠治疗,观察两组患儿炎症指标、临床症状缓解时间、疗效及复发情况。结果:治疗后,两组患儿各炎症指标均显著下降(P<0. 05),观察组白细胞介素-8、尿白三烯E4、嗜酸粒细胞阳离子蛋白、一氧化氮含量显著低于对照组(P<0. 05);观察组呼吸困难、湿啰音、咳嗽、憋喘消失时间及住院时间均显著短于对照组(P<0. 05);观察组总有效率显著高于对照组(P<0. 05),喘息及哮喘复发率显著低于对照组(P<0. 05);观察组复发喘息及哮喘持续时间均显著短于对照组,差异均有统计学意义(P<0. 05)。结论:孟鲁司特钠治疗RSV感染毛细支气管炎在近期、远期疗效上均具有一定优势,对于机体内RSV引起的相关炎症反应能够起到较好的控制作用。
Objective: To probe into the efficacy of montelukast in the treatment of children with bronchiolitis induced by respiratory syncytial virus( RSV) infection and its effects on inflammatory factor levels. Methods: Totally 154 children with bronchiolitis induced by RSV infection admitted into pediatrics department of our hospital from Mar. 2016 to Apr. 2017 were extracted to be divided into the control group and the observation group via the random number table,with 77 cases in each group. The control group was given conventional treatment,while the observation group additionally received montelukast based the conventional treatment. Inflammatory indicators,relief time of clinical symptoms,efficacy and recurrence were observed in two groups. Results: After treatment,the inflammatory indexes of two groups decreased significantly( P < 0. 05),the levels of interleukin-8,urinary leukotriene E4,eosinophil cationic protein and nitric oxide in the observation group were significantly lower than those in the control group( P < 0. 05). The disappearance time of dyspnea,moist rales,cough and dyspnea and hospitalization time in the observation group were significantly shorter than those in the control group( P<0. 05). The total effective rate of the observation group was significantly higher than that of the control group( P<0. 05),and the recurrence rate of wheezing and asthma was significantly shorter than that of the control group; the duration of recurrent wheezing and asthma in the observation group was significantly shorter than that in the control group,with statistically significant differences( P<0. 05). Conclusion: Montelukast in the treatment of children with bronchiolitis induced by RSV infection has certain advantages in both short-term and long-term effects,which can effectively control the related inflammatory response induced by RSV in the body.
Objective: To probe into the efficacy of montelukast in the treatment of children with bronchiolitis induced by respiratory syncytial virus( RSV) infection and its effects on inflammatory factor levels. Methods: Totally 154 children with bronchiolitis induced by RSV infection admitted into pediatrics department of our hospital from Mar. 2016 to Apr. 2017 were extracted to be divided into the control group and the observation group via the random number table,with 77 cases in each group. The control group was given conventional treatment,while the observation group additionally received montelukast based the conventional treatment. Inflammatory indicators,relief time of clinical symptoms,efficacy and recurrence were observed in two groups. Results: After treatment,the inflammatory indexes of two groups decreased significantly( P < 0. 05),the levels of interleukin-8,urinary leukotriene E4,eosinophil cationic protein and nitric oxide in the observation group were significantly lower than those in the control group( P < 0. 05). The disappearance time of dyspnea,moist rales,cough and dyspnea and hospitalization time in the observation group were significantly shorter than those in the control group( P<0. 05). The total effective rate of the observation group was significantly higher than that of the control group( P<0. 05),and the recurrence rate of wheezing and asthma was significantly shorter than that of the control group; the duration of recurrent wheezing and asthma in the observation group was significantly shorter than that in the control group,with statistically significant differences( P<0. 05). Conclusion: Montelukast in the treatment of children with bronchiolitis induced by RSV infection has certain advantages in both short-term and long-term effects,which can effectively control the related inflammatory response induced by RSV in the body.
引文
[1]侯秀玲,王敬敏,李桂娥,等.京南保北地区毛细支气管炎流行病学及病原学调查分析[J].儿科药学杂志,2015,21(11):12-15.
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[8]李根,张建青.利巴韦林雾化治疗呼吸道合胞病毒性毛细支气管炎的疗效观察[J].中国基层医药,2015(18):2757-2759.
[9]LU S,HARTERT T V,EVERARD M L,et al. Predictors of asthma following severe respiratory syncytial virus(RSV)bronchiolitis in early childhood[J]. Pediatr Pulmonol,2016,51(12):1382-1392.
[10]曾科学.糖皮质激素在毛细支气管炎治疗中的应用[J].实用中西医结合临床,2015,15(12):30-31.
[11]TENERO L, PIAZZA M, SANDRI M, et al. Effect of montelukast on markers of airway remodeling in children with asthma[J]. Allergy&asthma proceedings,2016,37(5):77.
[12]周玎,傅美红,王嘉漫,等.思力华对慢性阻塞性肺疾病患者中性粒细胞、IL-8及TNF-α水平的影响[J].现代生物医学进展,2017,17(12):2306-2309.
[13]BAO W,PING L,QIU Z,et al. Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis:The additive effect on airway inflammation,cough and life quality[J]. Chin Med J(Engl),2015,128(1):39-45.
[14]张媛,张铁栓.孟鲁司特联合布地奈德治疗嗜酸粒细胞性支气管炎的疗效及预防复发作用[J].实用医学杂志,2016,32(1):121-123.
[2]PICKLES R J,DEVINCENZO J P. Respiratory syncytial virus(RSV)and its propensity for causing bronchiolitis[J]. Journal of pathology,2015,235(2):266-276.
[3]刘钢铁,薛月玲,杨爱青,等.毛细支气管炎患儿血清25-(OH)D3、LL-37水平变化及意义[J].山东医药,2016,56(8):75-77.
[4]ELGIZOULI M,LOGAN C,GRYCHTOL R,et al. Reduced PRF1 enhancer methylation in children with a history of severe RSV bronchiolitis in infancy:An association study[J]. BMC Pediatrics,2017,17(1):65.
[5]史小义.普米克令舒和可必特雾化吸入治疗哮喘性支气管炎的临床分析[J].中国医药导刊,2015(1):69-70.
[6]陈进庆.孟鲁司特钠辅助治疗合胞病毒毛细支气管炎的临床观察[J].中国药房,2015,26(32):4565-4567.
[7]TORGERSON D G,GIRI T,DRULEY T E,et al. Pooled sequencing of candidate genes implicates rare variants in the development of asthma following severe RSV bronchiolitis in infancy[J]. PLoS One,2015,10(11):e0142649.
[8]李根,张建青.利巴韦林雾化治疗呼吸道合胞病毒性毛细支气管炎的疗效观察[J].中国基层医药,2015(18):2757-2759.
[9]LU S,HARTERT T V,EVERARD M L,et al. Predictors of asthma following severe respiratory syncytial virus(RSV)bronchiolitis in early childhood[J]. Pediatr Pulmonol,2016,51(12):1382-1392.
[10]曾科学.糖皮质激素在毛细支气管炎治疗中的应用[J].实用中西医结合临床,2015,15(12):30-31.
[11]TENERO L, PIAZZA M, SANDRI M, et al. Effect of montelukast on markers of airway remodeling in children with asthma[J]. Allergy&asthma proceedings,2016,37(5):77.
[12]周玎,傅美红,王嘉漫,等.思力华对慢性阻塞性肺疾病患者中性粒细胞、IL-8及TNF-α水平的影响[J].现代生物医学进展,2017,17(12):2306-2309.
[13]BAO W,PING L,QIU Z,et al. Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis:The additive effect on airway inflammation,cough and life quality[J]. Chin Med J(Engl),2015,128(1):39-45.
[14]张媛,张铁栓.孟鲁司特联合布地奈德治疗嗜酸粒细胞性支气管炎的疗效及预防复发作用[J].实用医学杂志,2016,32(1):121-123.