ICS、孟鲁司特联合降阶梯治疗婴幼儿反复喘息临床研究  

Clinical research of Inhaled corticosteroids(ICS),montelustra combined with descending ladder in the treatment of infants with repeated wheezing

作　　者：王执勇[1] 李树青[1] 钱秀玲[1] WANG Zhiyong;LI Shuqing;QIAN Xiuling(Department of Pediatrics,Weifang Maternal and Child Health Hospital,Weifang 261011,China)

机构地区：[1]潍坊市妇幼保健院儿科,山东潍坊261011

出　　处：《潍坊医学院学报》2020年第3期177-179,236,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫生局科研项目(项目编号:2014006)。

摘　　要：目的探讨吸入性糖皮质激素(ICS)、孟鲁司特联合降阶梯治疗婴幼儿反复喘息的有效性和安全性。方法选择2017年6月~2018年6月在潍坊市妇幼保健院住院的反复喘息婴幼儿为研究对象,随机分为实验组和对照组,各60例。实验组给予辅舒酮﹢储物罐吸入、孟鲁司特联合降阶梯治疗,总疗程3~6个月;对照组应用安慰剂,用法与实验组相同。结局指标:两组经医生确认新发喘息;次要结局指标:两组喘息发作次数,因喘息发作需住院治疗例数。结果实验组28例(46.67%)和对照组42例(70.00%)患儿出现新发喘息,Log-rank检验显示差异有显著性(P=0.01);实验组患儿总共发生39次喘息,对照组发生72次,Mann-Whitney U检验显示差异有显著性(P<0.01);实验组住院人数与对照组比较,差异有显著性(P=0.02);治疗前后两组身高、体重比较,差异无显著性(P>0.05)。结论反复喘息婴幼儿给予ICS、孟鲁司特联合降阶梯治疗,可以减少再发生喘息人数,减少喘息的发作次数和因喘息发作的住院次数,副作用小,值得临床推广。Objective To investigate the efficacy and safety of Inhaled corticosteroids(ICS),montelustra combined with descending ladder in the treatment of infants with recurrent wheezing.Methods Infants with recurrent wheezing who were hospitalized in Weifang Maternal and Child Health Hospital in June 2017 and June 2018 were selected as the study subjects and randomly divided into experimental group(60 cases) and control group(60 cases).The experimental group was given Flixotide+ storage tank,montelustra combined with descending ladder treatment fora total course of treatment from 3 to 6 months.The control group was given placebo,with the same usage as the experimental group.Primary outcome:the two groups were confirmed by the doctor to have new wheezing;Secondary outcome:the number of wheezing episodes in the two groups,and the number of hospitalized patients for wheezing episodes.Results At the end of the study,28 cases(46.67%) of the experimental group and 42 cases(70.00%) of the control group showed new wheezing,and the log-rank test showed that the difference was statistically significant(χ^2=6.03,P=0.01);A total of 39 wheezing episodes occurred in the experimental group and 72 in the control group.Mann-whitney U test showed statistically significant differences(Z=-2.95,P<0.01);The difference between the experimental group and the control group was statistically significant(χ^2=5.21,P=0.02);There was no significant difference in height and weight between the two groups before and after treatment(P>0.05).Conclusion Inhaled corticosteroi、montelustra combined with descending ladder therapy for recurrent wheezing of infants can reduce the number of patients with recurrent wheezing,reduce the occurrence of wheezing and hospitalization number,with less side effects and worthy of clinical promotion.

关 键 词：吸入性糖皮质激素 孟鲁司特 降阶梯治疗 婴幼儿 反复喘息 

分 类 号：R725.6[医药卫生—儿科]