孟鲁司特联合丙酸氟替卡松对毛细支气管炎后气道炎症的干预作用  

Intervention of montelukast combined with fluticasone propionate in the treatment of airway in- flammation for post-bronchiolitis

作　　者：郝珉[1] 宋文[1] 任泽东[1] 

机构地区：[1]山东省枣庄市立医院儿科,277100

出　　处：《中国实用医刊》2013年第16期47-49,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨孟鲁司特联合丙酸氟替卡松对毛细支气管炎后气道炎症的干预作用及临床疗效。方法100例毛细支气管炎患儿随机分为干预组和对照组。入院后给予常规治疗并测IL-4、INF-γECP和LTE4。病情控制后，干预组给予孟鲁司特钠4mg，每晚1次，和丙酸氟替卡松1喷，每天1次，疗程为3个月。对照组不予任何干预治疗。疗程结束后（对照组病情控制3个月后）复查各指标。并随访1年，观察各组患儿3个月内喘息再次发作例数和1年内喘息发作I〉3次例数。结果干预组和对照组干预后IL-4、ECP、LTE4水平和IL-4／IFN-γ均较干预前显著降低，而INF-γ较干预前显著升高（P〈0．05或0．01），且干预组较对照组指标变化更为显著（P〈0．05或0．01）。干预组患儿3个月内喘息再次发作例数和1年内喘息发作≥3次例数均较对照组患儿显著减少（P〈0．05）。结论孟鲁司特联合丙酸氟替卡松可有效控制毛细支气管炎后气道炎症，减少喘息发作。Objective To investigate the intervention and the curative effect of montelukast com- bined with fluticasone propionate in the treatment of airway inflammation for post-bronchiolitis. Methods One hundred children with bronchiolitis were randomly divided into the intervention group and the control group. All patients were given conventional therapy and determined the level of IL-4, INF-γ, ECP, LTE4 after hospitalization. When the conditions were stable, the intervention group were treated with montelukast 4 mg qn and iluticasone propionate 1 spray qd for 3 months. The control group were not giv- en any treatment. The level of IL-4, INF-γ, ECP, LTE4 were reexamine after 3 months. To count the cases of recurrence of asthma within 3 months and recurrence more than 3 times one year by follow-up for one year. Results The level of IL-4, ECP, LTE4 and IL-4 IFN-γ were significantly lower in the two groups after intervention than before, and the level of IFN-γ were higher （P 〈 0.05 or 0.01 ）. The level of IL-4, IgE, EOS and IL-4 IFN-γ were higher in the intervention group than that of control group and level of IFN-＇y were lower after treatment （P 〈 0.05 or 0. 01 ）. The recurrence cases of asthma within 3 months and recurrence more than 3 times one year in the intervention group were significantly reduced than control group （P 〈 0.05 ）. Conclusions Montelukast combined with flu- ticasone propionate can effectively control airway inflammation for post-bronchiolitis and reduce asth- ma attacks times.

关 键 词：孟鲁司特 丙酸氟替卡松 毛细支气管炎 气道炎症 干预 疗效 

分 类 号：R725.6[医药卫生—儿科]