孟鲁司特对过敏性紫癜患儿尿白三烯的影响

目的测定尿LTE4变化,探讨孟鲁司特治疗过敏性紫癜（HSP）的疗效。方法60例患儿随机分为两组各30例,急性期均予常规治疗,治疗组同时孟鲁司特口服,恢复期继续孟鲁司特治疗2周;对照组恢复期泼尼松治疗2周。ELISA法检测两组治疗前、后尿LTE4水平。结果维持治疗1周,治疗组比对照组LTE4下降更明显（t=28．860,P〈0．05）,但仍高于正常（F=46．268,P〈0．05）,需继续治疗。维持治疗2周,两组患儿尿LTE4接近正常（F=2．796,P〉0．05）,且治疗组比对照组下降更明显（t=4．777,P〈0．05）。两组肾脏损害无统计学意义（χ^2=-0．218,P〉0．05）。结论LTE4参与了HSP发病过程,孟鲁司特治疗HSP可提高疗效、改善预后,副作用小。     

孟鲁司特钠对小于5岁咳嗽变异性哮喘患儿EOS及血清总IgE水平的影响

目的观察孟鲁司特钠对〈5岁咳嗽变异性哮喘患儿外周血嗜酸性粒细胞计数及血清总IgE水平变化的影响。方法将2011年l-12月我科门诊入选的67例咳嗽变异性哮喘患儿,随机分为两组,30例为对照组给予常规的治疗,而观察组37例则在常规治疗的基础上给予孟鲁司特钠治疗。治疗前后分别测定患儿外周血嗜酸性粒细胞计数及血清总IgE。结果对照组治疗前后外周血嗜酸性粒细胞计数分别为（0．91±0．35）×109／L、（0．74±0．21）×10^9／L：治疗组治疗前后血嗜酸性粒细胞计数分别为（O：79±0．14）×109／L、（0．42±0.07）×10^9／L,治疗前后比较差异有高度统计学意义（P〈0．01）;对照组治疗前后血清总IgE水平分别为（90．17±14．06）、（88．65±18．13）IU／mL：治疗组治疗前后血清总IgE水平分别为（89．34±10．24）、（86．32±7．19）IU／mL,治疗前后比较差异有高度统计学意义（P〈0．01）：治疗3个月后两组比较差异有高度统计学意义（P〈0．01）。结论孟鲁司特钠疗效确切,依从性好,口服方便,可降低〈5岁咳嗽变异性哮喘患儿的血清总IgE水平,通过了解观察外周血嗜酸性粒细胞计数、血清总IgE水平的变化对咳嗽变异性哮喘的诊断治疗具有重要的临床指导意义。     

孟鲁司特钠治疗儿童咳嗽变异性哮喘45例疗效观察

目的探讨孟鲁司特钠治疗儿童咳嗽变异性哮喘(CVA)的临床效果。方法选择2010年3月～2011年2月在我科门诊就诊的90例CVA患者,随机分为观察组和对照组。对照组用吸入布地奈德加孟鲁司特钠及对症治疗,观察组单用孟鲁司特钠及对症治疗。结果观察组总有效率为93.3%,对照组总有效率为97.8%。两组比较差异无明显统计学意义(P>0.05)。治疗后两组患儿肺功能测定与治疗前比较,FEV1、FVC和PEF值均有改善,但两组治疗后其肺功能指标比较差异无统计学意义(P>0.05)。结论单用孟鲁司特钠治疗咳嗽变异性哮喘有明显疗效,无明显副作用,值得推广和应用。     

孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床疗效观察

目的探讨孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床疗效。方法将100例咳嗽变异性哮喘患儿随机分为治疗组和对照组,每组各50例,治疗组予以孟鲁司特及沙丁胺醇气雾剂治疗,对照组予以辅舒酮、沙丁胺醇气雾剂治疗;比较两组患儿的近期疗效、症状缓解时间和复发率。结果治疗组的有效率为90%,明显高于对照组的56%,两组比较差异有统计学意义(χ2=19.441,P=0.001)。治疗组哮喘症状缓解时间为(5.9±2.6)d,而对照组为(8.0±3.2)d,两组比较差异有统计学意义。治疗结束6个月后,治疗组复发率为12%(6/50),对照组复发率为38%(19/50),两组比较差异有统计学意义(χ2=9.013,P=0.003)。结论孟鲁司特钠治疗小儿咳嗽变异性哮喘疗效确切,有效性高,复发率低,安全性好,值得临床推广。     

孟鲁司特佐治毛细支气管炎41例疗效观察

目的观察孟鲁司特治疗毛细支气管炎临床疗效及对远期喘息复发的影响。方法患儿年龄6个月～2岁,随机分为两组,对照组40例,治疗组41例,两组患儿均给予相同的综合治疗,治疗组在上述常规治疗基础上加用孟鲁司特(顺尔宁)每次4 mg,每晚1次口服,观察两组病儿喘憋缓解、肺部哮鸣音消失时间及痊愈时间,并比较两组疗效,所有患儿均随访6个月,治疗组随访期间每晚继续口服4 mg顺尔宁,观察两组随访期间再次喘息发作次数。结果治疗组总有效率高于对照组,两组比较差异有统计学意义(χ2=7.204,P=0.007<0.05),治疗组在喘憋缓解、肺部哮鸣音消失时间及痊愈时间均少于对照组,两组比较差异有统计学意义,随访期间再次发生喘息情况:对照组13例,发生率13/40,治疗组例4例,发生率4/41,两组比较差异有统计学意义(χ2=5.019,P=0.025<0.05)。结论加用孟鲁司特治疗毛细支气管炎可有效缓解临床症状、缩短痊愈时间并能降低喘息再发率。     

孟鲁司特钠治疗儿童感染后咳嗽的临床疗效观察

目的:观察白三烯受体拮抗剂孟鲁司特钠治疗儿童感染后咳嗽的临床疗效。方法:我院2010年4月～2011年4月诊治的感染后咳嗽患儿129例,随机分为对照组、布地奈德治疗组和孟鲁司特钠治疗组共三组,分别给予阿奇霉素干混悬剂、阿奇霉素干混悬剂联合布地奈德及阿奇霉素干混悬剂联合孟鲁司特钠治疗,观察三组咳嗽症状评分变化、显效时间及有效率。结果:与对照组比较,孟鲁司特钠和布地奈德可以明显改善感染后咳嗽患儿的咳嗽症状评分、缩短显效时间、提高总有效率(P<0.05),但孟鲁司特钠治疗组和布地奈德治疗组两者间比较差异无统计学意义(P>0.05)。结论:孟鲁司特钠治疗儿童感染后咳嗽疗效明确、依从性好,值得临床推广。     

孟鲁司特钠咀嚼片含量测定及初步稳定性研究

目的为实现对孟鲁司特钠咀嚼片质量的关键指标的控制和制剂稳定性研究。方法建立一种专属性好,灵敏度高,快速,准确的HPLC分析方法,测定3批次孟鲁司特钠咀嚼片中孟鲁司特钠含量;并通过高温、高湿度、强光照射试验和加速试验及长期稳定性试验,进行制剂的初步稳定性试验。结果建立的方法经验证,孟鲁司特钠的线性范围为0.5～16.0μg/mL,检测限为0.12μg/mL,定量限为0.39μg/mL,平均加样回收率分别是99.7%、101.2%和99.8%,精密度试验RSD值为1.04%、1.23%和1.27%,初步稳定性试验中含量变化的RSD值均为1.22%、1.67%和1.45%。结论该方法分析时间短、专属性好、准确度高,可用于孟鲁司特钠咀嚼片中孟鲁司特钠含量测定。孟鲁司特钠咀嚼片质量稳定,符合要求。     

Influence of Leukotriene Inhibitor Montelukast on Wound Contraction and Cutaneous Healing Process in Rats

Background  Wound contractures can cause severe deformities and disabilities. Recent studies have suggested that leukotriene receptor antagonists have an inhibitory effect on the healing contraction process. This study aimed to evaluate the influence of the leukotriene inhibitor montelukast on the cutaneous healing process and the wound contraction phenomenon in rats. Methods  For this study, 60 male rats were randomly divided into four groups (MK-7d, SF-7d, MK-14d, and SF-14d) according to the drug given through a rigid orogastric tube (MK group: montelukast 10 mg/kg/day; SF group: normal saline solution) and the day the animals were killed (7d: postoperative day 7; 14d: postoperative day 14). An excisional wound (2 × 2 cm) was created on the dorsum of each rat. The wounds were left open to heal spontaneously and documented by standard digital photographs on different postoperative days. Wound contraction rates were calculated with specific software, and specimens were histologically evaluated using picrosirius red stain. Results were analyzed using the Aspin-Welch, Mann–Whitney, and t tests, assuming a significance level of 5%. Results  The wound contraction rates were similar between the control and study groups (p > 0.05). On postoperative day 7, the wounds showed a marginally significant reduction in collagen maturation in the study group (40.1% ± 6.88% vs 61.2% ± 8.02%; p = 0.0607). On postoperative day 14, this reduction was statistically significant in the MK group (26% ± 5.66% vs 68.3% ± 7.76%; p = 0.0001). Conclusions  Montelukast does not alter the contraction rate of excisional wounds in rats but has a significant and progressive inhibitory effect on collagen maturation. This study was developed by the Post-Graduate Program in Surgery and Plastic and Reconstructive Surgery Unit of Federal University of Paraná, Curitiba, Brazil.     

Leukotrienes C4 and D4 sensitize human neutrophils for hyperreactivity to chemoattractants

Objective and design:  To investigate the sensitizing effects of the cysteinyl leukotrienes (CysLTs) C₄ and D₄ on the proinflammatory responses of chemoattractant-activated human neutrophils in vitro. Materials:  Neutrophils were isolated from venous blood taken from healthy, adult, human volunteers. Treatment:  Cells were exposed to LTC₄ and LTD₄ (50–300 nM) prior to activation with 1 μM of N-formyl-L-methionyl- L-leucyl-L-phenylalanine (fMLF). Methods:  A fura-2/AM-based spectrofluorimetric procedure, lucigenin-enhanced chemiluminescence (LECL), a colourimetric method and an ELISA procedure, were used to measure Ca²⁺ mobilization, superoxide production, elastase and MMP-8 release respectively following activation of LTC₄/ D₄-primed neutrophils with fMLF. Superoxide generation was also measured in the presence and absence of the CysLT receptor 1 antagonist, montelukast (100 nM). Results:  Exposure of neutrophils to either LTC₄ or LTD₄ alone had modest effects on Ca₂₊ mobilization, while superoxide generation and elastase release were unaffected. However, relative to the responses of neutrophils activated with fMLF in the absence of the CysLTs, pre-treatment of the cells with either LTC₄or LTD₄ resulted in significant, augmentation of fMLF-activated elastase and MMP-8 release and superoxide generation, which was attenuated by montelukast. Conclusion  These previously undocumented sensitizing interactions of LTs C₄ and D₄ with neutrophils may contribute to the activation of these cells in acute and chronic inflammation of both atopic and non-atopic aetiology, while identifying a role for montelukast in regulating neutrophil reactivity. Received 6 March 2008; returned for revision 16 May 2008; received from final revision 15 August 2008; accepted by A. Falus 4 November 2008     

糠酸莫米松联合孟鲁司特治疗小儿变应性鼻炎的疗效观察

目的：观察联合应用糠酸莫米松吸入和口服孟鲁司特钠治疗儿童变应性鼻炎的疗效。方法：141例变应性鼻炎患儿随机分为4组,分别使用糠酸莫米松、孟鲁司特钠、糠酸莫米松和孟鲁司特钠联合、氯雷他定治疗,疗程8周,治疗前后症状体征评分,统计有效率。结果：前3组比氯雷他定组评分改善,总有效率高,差异有统计学意义（P〈0.05）。糠酸莫米松组和孟鲁司特组无显著差异（P〉0.05）。联合治疗组比糠酸莫米松组和孟鲁司特组评分改善,总有效率高,差异有统计学意义（P〈0.05）。结论：联合应用糠酸莫米松吸入和口服孟鲁司特钠治疗儿童变应性鼻炎,疗效优于单药治疗。