孟鲁司特钠治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效观察

目的：观察白三烯受体拮抗剂孟鲁司特钠治疗儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效。方法：将68例OSAHS患儿随机分为观察组39例和对照组29例。对照组给予抗组胺、化痰止咳等对症治疗及对血象明显升高者加用抗生素等常规综合治疗，观察组在对照纽治疗基础上加用孟鲁司特钠，〈5岁每次4mg，≥5岁每次5mg，每日1次，睡前口服，常规疗程12周。观察治疗前后两纽患儿呼吸相关睡眠障碍症状指标评分、腺样体／鼻咽腔比值（A／N）、扁桃体大小，分析疗效。结果：（1）观察组治疗后呼吸相关睡眠障碍症状指标评分、A／N、扁桃体明显小于治疗前（P〈0．01），而对照组治疗前后比较差异无统计学意义（P〉0．05），治疗后观察组OSAHS症状总评分及A／N与对照组比较差异有统计学意义（P〈0．01）；（2）观察组打鼾、鼻塞、睡眠不安治疗有效率分别为94．87％、89．74％、94．44％，对照组分别为65．52％、58．62％、62．96％，两组比较差异均具有统计学意义（P均〈0．01）。结论：孟鲁司特钠治疗儿童OSAHS能不同程度地减轻临床症状，缩小扁桃体、腺样体，提高疗效。

Observation of Effect of Montelukast in the Treatment of Children with Obstructive Sleep Apnea Hypopnea Syndrom

Objective： To observe the effect of Montelukast in the treatment of children with obstructive sleep apnea hypopnea syndrom （OSAHS） , and to explore the feasibility of LTs receptor antagonist in the treatment of OSAHS. Methods： OSAHS children were divided into an observation group and a control group. Both groups were given symptomatic treatment and antibiotics. The observation group was given LTs receptor antagonist （montelukast sodium） for twelve weeks additionally. The respiratory-related sleep disorder symptom index, A/N and the changes of tonsil size were observed. Results： After treatment for twelve weeks ： ① the respiratory-related sleep disorder symptom index score and A/N of the observation group were significantly lower than those before treatment （P〈0.01） ; the above indicators of the control group were not significantly different before and after treatment （P〉0.05） ; compared with the control group, OSAHS symptoms total score and A/N of the observation group after treatment was statistically different （P〈0.01） ; ② The recovery of snoring, nasal congestion and disturbed sleep of the observation group and the control group were 94.87% vs 65.52% , 89.74% vs 58.62% , and 94.44% vs 62.96% ; the differences were statistically significant （ P〈0.01 ） ; ③ The tonsils of the observation group was significantly shrunk after treatment ; the tonsils of the control group had no significant difference before and after treatment ; the tonsils of the observation group after treatment were statistically smaller than those of the control group. Conclusions： Montelukast can alleviate clinical symptoms and shrink the volume of tonsils and adenoids. It has good clinical efficacy.