二联药物方案对腺样体肥大患儿近期疗效、生命质量及复发率的影响  

Influence of bigeminy drug regimen on short-term effects, quality of life and recurrence rate in children with adenoid hypertrophy

作　　者：钱江 张洪[1] 魏云[1] 李森[1] 张茜蕾 刘竺 Qian Jiang;Zhang Hong;Wei Yun;Li Seng;Zhang Xilei;Liu Zu(Department of Otorhinolaryngology Head and Neck Surgery,Dazhou Integrated Traditional Chinese and Western Medicine Hospital,Sichuan Dazhou 635000,Chin)

机构地区：[1]四川省达州市中西医结合医院耳鼻咽喉头-颈外科,635000

出　　处：《中国医师进修杂志》2018年第8期724-727,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨二联药物方案对儿童腺样体肥大患儿近期疗效、生命质量及复发率的影响。方法选取2014年1月至2016年12月收治儿童腺样体肥大患儿共130例，以随机数字表法分为对照组（65例）和观察组（65例），分别给予单纯鼻用糖皮质激素和在此基础上加用孟鲁司特钠辅助治疗；比较两组患儿近期疗效，治疗前后A/N水平、血清炎性细胞因子水平、特异性生命质量调查（OSA-18）及随访复发率。结果观察组患儿近期疗效显著优于对照组[92.31%（60/65）比73.85%（48/65）]（P〈0.05）；观察组患儿治疗后A/N水平显著低于对照组、治疗前（0.60 ± 0.07比0.74 ± 0.10、0.94 ± 0.15）（P〈0.05）；观察组患儿治疗后白细胞介素（IL）-1β、IL-2及IL-4水平均显著低于对照组、治疗前[IL-1β：（1.50 ± 0.48）ng/L比（2.21 ± 0.44）、（3.42 ± 0.68）ng/L；IL-2：（21.80 ± 2.08）ng/L比（24.28 ± 2.50）、（26.61 ± 3.35）ng/L；IL-4：（179.12 ± 35.91）ng/L比（244.70 ± 44.42）、（284.07 ± 51.87）ng/L]（P〈0.05）；观察组患儿治疗后OSA-18评分显著低于对照组、治疗前（P〈0.05）；同时对照组和观察组随访复发率分别为32.31%（21/65）、15.39%（10/65）；观察组患儿随访复发率显著低于对照组（P〈0.05）。结论二联药物方案治疗儿童腺样体肥大可显著减轻呼吸阻塞程度，降低炎性反应水平，改善日常生命质量，且有助于预防远期复发。Objective To investigate the influence of bigeminy drug regimen on short-term clinical effects, quality of life and recurrence rate in children with adenoid hypertrophy.MethodsOne hundred and thirty patients with adenoid hypertrophy were chosen in the period from January 2014 to December 2016. They were randomly divided into 2 groups：control group （65 patients, nasal glucocorticoid used alone） and observation group （65 patients, montelukast sodiumon the basis of control group）. The short-term clinical effect, the levels of A/N, serum inflammatory cytokine and OSA-18 score before and after treatment and recurrence rate of 2 groups were compared.ResultsThe short-term clinical effects of control group and observation group were separately 73.85%（60/65） and 92.31% （48/65）. The levels of A/N after treatment in observation group were significantly lower than those in control group and before treatment： 0.60 ± 0.07 vs. 0.74 ± 0.10, 0.94 ± 0.15 （P〈0.05）. The levels of IL-1β, IL-2 and IL-4 after treatment in observation group were significantly lower than those in control group and before treatment：IL-1β： （1.50 ± 0.48） ng/L vs. （2.21 ± 0.44）, （3.42 ± 0.68） ng/L; IL-2： （21.80 ± 2.08） ng/L vs. （24.28 ± 2.50）, （26.61 ± 3.35） ng/L; IL-4： （179.12 ± 35.91） ng/L vs. （244.70 ± 44.42）, （284.07 ± 51.87） ng/L （P〈0.05）. The OSA-18 score after treatment in observation group was significantly lower than that in control group and before treatment （P〈0.05）. The recurrence rate in control group and observation group was separately 32.31%（21/65） and 15.39%（10/65）. The recurrence rate in observation group was significantly lower than that in control group （P〈0.05）.ConclusionsBigeminy drug regimen in the treatment of children with adenoid hypertrophy can efficiently relieve the respiratory obstruction degree, reduce the levels of inflammatory response, improve the quality of daily life and be helpful to prevent long-term recurrence.

关 键 词：激素类 儿童 治疗结果 腺样体肥大 

分 类 号：R766[医药卫生—耳鼻咽喉科]