孟鲁司特对呼吸道合胞病毒毛细支气管炎后气道炎症的干预作用  

The effect of Montelukast on the treatment of children with respiratory syncytial virus bronchiolitis

作　　者：赵茜叶[1] 孙乾[1] 丁铁梅[1] 周旭华[1] 于艳艳[1] 夏丽娟[1] 吴培培[1] 宋继成[1] 王刚[1] 

机构地区：[1]江苏省连云港市妇幼保健院,222006

出　　处：《中国妇幼保健》2011年第20期3083-3085,共3页Maternal and Child Health Care of China

基　　金：连云港市卫生局资助项目〔ZC325〕

摘　　要：目的:通过检测炎症因子白介素-5(interleukin-5)和嗜酸粒细胞趋化蛋白(Eotaxin)的变化及呼吸道合胞病毒(RSV)毛细支气管炎(毛支)后3月内的喘息情况,探讨孟鲁司特对RSV毛支后气道炎症的干预作用。方法:选择88例初次喘息发作的具有特应性体质的患儿作为研究对象,40例毛支患儿为对照组予常规治疗,48例在常规治疗的同时口服孟鲁司特钠为观察组。分别在急性期及恢复期检测血清IL-5及Eotaxin水平的变化,门诊随访3月,观察有无喘息再次发作。结果:RSV毛支患儿急性期血清IL-5及Eotaxin水平明显增高,经孟鲁司特干预后,恢复期IL-5及Eotaxin水平明显下降。3个月内喘息再次发作人数比较两组差异有统计学意义(P<0.01)。结论:RSV毛支患儿急性期炎症因子IL-5及Eotaxin水平明显增高,孟鲁司特对RSV毛支IL-5和Eotaxin有下调作用,可控制RSV毛细支气管炎后的气道炎症,对毛支后喘息的反复发作具有预防作用。Objective：To explore the effect of Montelukast on the treatment of airway inflammation in the bronchiolitis after respiratory syncytial virus（RSV） infection by studying the clinical manifestations and change of serum concentration of inflammatory cellular factors including interleukin-5（IL-5） and Eotaxin.Methods：88 infants with bronehiolifis caused by primary infection of RSV associated with atopy were recruited in the study and they were randomly divided into two groups,40 cases were selected as the control group,they were treated with conventional therapy.48 cases were selected as the observe group,they were treated with Montelukast in addition to conventional therapy.Blood samples were collected on the first day on admission before treatment and recovery phase of the disease.Follow up was done to observe recurrence for 3 months.Results：IL-5 and Eotaxin level in patients during acute phase of the disease were significantly higher than those during recovery phase,the level of I1-5 and Eotaxin were decreased distinctly by Montelukast.moreover.The differences in patients with reccurrence of wheeze between observe group and control group were significant.Conclusion：IL-5 and Eotaxin level are significatly higher in patients with respiratory syncytial virus bronchiolitis during acute phase of the disease.Montelukast may decrease the serum concentrations of IL-5,Eotaxin and control airway inflammation in the bronchiolitis after RSV,it may play a role in the prevention of recurrence attacks of wheeze after bronchiolitis.

关 键 词：孟鲁司特钠 呼吸道合胞病毒 毛细支气管炎 白介素-5 嗜酸粒细胞趋化蛋白 

分 类 号：R725.6[医药卫生—儿科]