Characteristics of respiratory syncytial virus-induced bronchiolitis co-infection with Mycoplasma pneumoniae and add-on therapy with montelukast  

作　　者：Sheng-Hua Wu Xiao-Qing Chen Xia Kong Pei-Ling Yin Ling Dong Pei-Yuan Liao Jia-Ming Wu 

机构地区：[1]Department of Pediatrics,First Affi liated Hospital of Nanjing Medical University,300 Guangzhou Road,Nanjing 210029,China [2]Department of Pediatrics,Jiangsu Maternity and Children Healthcare Hospital,Nanjing 210036,China [3]Department of Pediatrics,Nanjing First Hospital Affi liated to Nanjing Medical University,Nanjing 210006,China [4]Department of Pediatrics,Central Hospital of Tengzhou,Tengzhou 277500,China [5]Department of Pediatrics,Qidong People's Hospital,753 Central Jianghai Road,Qidong 226200,China

出　　处：《World Journal of Pediatrics》2016年第1期88-95,共8页世界儿科杂志（英文版）

基　　金：supported by a grant from the Priority Academic Program Development of Jiangsu Higher Education Institution(JX10231801).

摘　　要：Background:The influence of Mycoplasma pneumoniae(MP)infection on bronchiolitis remains unclear.Additionally,reports on the efficacies of leukotriene receptor antagonists in the treatment of bronchiolitis have been inconclusive.Methods:Children with respiratory syncytial virus(RSV)-induced bronchiolitis were divided into two groups:RSV+MP group and RSV group.Each group was randomly divided into two subgroups:one received routine and placebo treatment,while the other received routine and montelukast treatment for 9 months.The cumulative numbers of wheezing episodes and recurrent respiratory tract infections were recorded.Blood parameters were determined.Results:Patients in the RSV+MP group exhibited an older average age,fever,more frequent flaky and patchy shadows in chest X-rays,more frequent extrapulmonary manifestations,and longer hospital stays compared with patients in the RSV group.Additionally,higher baseline blood eosinophil counts,eosinophil cationic protein(ECP),total immunoglobulin E(IgE),interleukin(IL)-4,IL-5,IL-4/interferon-γratios,leukotriene(LT)B4,and LTC4,and lower baseline lipoxin A4(LXA4)/LTB4 ratios were observed in the RSV+MP group compared with the RSV group.Montelukast treatment decreased the cumulative numbers of recurrent wheezing episodes and recurrent respiratory tract infections at 9 and 12 months.This efficacy may be related to the montelukast-induced reductions in peripheral eosinophil counts,ECP and total IgE,as well as the montelukast-dependent recovery in T helper(Th)1/Th2 balance and LXA4/LTB4 ratios in children with bronchiolitis.Conclusions:RSV bronchiolitis with MP infection was associated with clinical and laboratory features that differed from those of RSV bronchiolitis without MP infection.Add-on therapy with montelukast for 9 months was benefi cial for children with bronchiolitis at 9 and 12 months after the initiation of treatment.

关 键 词：BRONCHIOLITIS LEUKOTRIENES MONTELUKAST Mycoplasma pneumoniae respiratory syncytial virus 

分 类 号：R72[医药卫生—儿科]