喘息性支气管炎患儿经甲泼尼龙和孟鲁司特钠治疗的效果及对运动耐力的影响  

Effect of treatment with methylprednisolone and montelukast sodium in children with wheezing bronchitis and the effect on exercise tolerance

作　　者：宁成利 朱占魁 侯杏杏 NING Cheng-li;ZHU Zhan-kui;HOU Xing-xing(Department of Pediatrics,Fuyang Women and Children's Hospital,Fuyang Anhui 236504,China)

机构地区：[1]阜阳市妇女儿童医院儿科,安徽阜阳236504

出　　处：《临床和实验医学杂志》2025年第1期58-62,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省妇幼保健协议项目(编号:AHFY202201)。

摘　　要：目的 研究甲泼尼龙联合孟鲁司特钠治疗喘息性支气管炎患儿的效果及对运动耐力的影响。方法 前瞻性选取2020年1月至2023年6月阜阳市妇女儿童医院纳入的76例喘息性支气管炎患儿作为研究对象,按随机数字表法将其分为研究组(n=38)和对照组(n=38)。两组均接受抗感染、氧气支持、止咳化痰及平喘等常规对症治疗,对照组给予孟鲁司特钠治疗,研究组在对照组基础上给予甲泼尼龙治疗。比较两组的症状体征消失时间、住院时间,治疗前、治疗4周后的炎症因子[C反应蛋白(CRP)、降钙素原、白细胞计数(WBC)]、6 min步行距离(儿童版)、Borg呼吸困难评分以及不良反应发生情况。结果 研究组的胸片吸收、憋喘、咳嗽及哮鸣音消失时间、住院时间分别为(5.45±1.71)、(2.63±0.77)、(3.41±1.03)、(3.98±1.22)、(6.03±1.81) d,均短于对照组[(6.38±1.89)、(3.14±1.01)、(4.20±1.19)、(4.65±1.30)、(7.22±2.36) d],差异均有统计学意义(P<0.05)。治疗4周后,两组降钙素原、CRP、WBC水平均较治疗前降低,且研究组的降钙素原、CRP、WBC水平分别为(0.41±0.12) ng/mL、(4.55±1.31) ng/mL、(7.03±2.14)×10^(9),均低于对照组[(0.63±0.20) ng/mL、(7.91±2.23) ng/mL、(9.45±3.06)×10^(9)],差异均有统计学意义(P<0.05)。治疗4周后,两组6 min步行距离均较治疗前增大,Borg呼吸困难评分均较治疗前降低,且研究组6 min步行距离为(472.43±59.50) m,大于对照组[(436.11±56.24) m],Borg呼吸困难评分为(0.25±0.08)分,低于对照组[(0.41±0.12)分],差异均有统计学意义(P<0.05)。研究组总不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论 甲泼尼龙联合孟鲁司特钠在喘息性支气管炎中效果显著,不仅能够促进患儿症状快速消失,减少住院时间,同时减轻炎症反应,改善运动耐力,且不良反应少,安全性高。Objective To study the effect of methylprednisolone combined with montelukast sodium in the treatment of children with asthmatic bronchitis and its effect on exercise tolerance.Methods A total of 76 children with asthmatic bronchitis admitted to Fuyang Women and Children's Hospital from January 2020 to June 2023 were prospectively selected as the study subjects.They were divided into the study group(n=38)and the control group(n=38)according to the random number table method.Both groups received routine symptomatic treatment such as anti-infection,oxygen support,relieving cough and resolving phlegm,and relieving asthma.The control group was treated with montelukast sodium,and the study group was treated with methylprednisolone on the basis of the control group.The time to disappearance of symptoms and signs,hospitalization time,inflammatory factors[C-reactive protein(CRP),procalcitonin,white blood cell count(WBC)],6 min walking distance(children's version),Borg dyspnea score before and after 4 weeks of treatment and adverse reactions were compared between the two groups.Results The disappearance time of chest X-ray absorption,suffocation,cough and wheeze,and hospitalization time in the study group were(5.45±1.71),(2.63±0.77),(3.41±1.03),(3.98±1.22),and(6.03±1.81)d,respectively,which were shorter than those in the control group[(6.38±1.89),(3.14±1.01),(4.20±1.19),(4.65±1.30),(7.22±2.36)d],and the differences were statistically significant(P<0.05).After 4 weeks of treatment,the levels of procalcitonin,CRP and WBC in the two groups were lower than those before treatment,and the levels of procalcitonin,CRP and WBC in the study group were(0.41±0.12)ng/mL,(4.55±1.31)ng/mL and(7.03±2.14)×10^(9),respectively,which were lower than those in the control group[(0.63±0.20)ng/mL,(7.91±2.23)ng/mL,(9.45±3.06)×10^(9)],the differences were statistically significant(P<0.05).After 4 weeks of treatment,the 6-minute walking distance of the two groups was higher than that before treatment,and the Borg dyspnea score was

关 键 词：喘息性支气管炎 孟鲁司特钠 甲泼尼龙 胸片 

分 类 号：R725.6[医药卫生—儿科]