孟鲁司特防治婴幼儿反复病毒相关性喘息的临床观察

目的：观察孟鲁司特治疗及预防婴幼儿反复病毒相关性喘息的临床疗效。方法：有反复病毒相关性喘息史的喘息急性发作期患儿100例,随机分为观察组51例和对照组49例。两组均予抗炎、解痉、抗感染及布地奈德混悬液、支气管扩张剂雾化等常规治疗,必要时给予吸痰处理。观察组在急性期即加用孟鲁司特4 mg/次,1次/d口服,痊愈出院后再继续服用3个月,对照组在出院后不给予任何治疗。所有患儿随访1年。结果：（1）观察组和对照组咳嗽消失时间分别为（7.58±2.46）d、（8.35±2.61）d,气喘消失时间分别为（5.5±1.2）d、（6.0±1.4）d,两组比较差异均无统计学意义（P〉0.05）;（2）观察组和对照组出院后随访一年喘息发作次数分别为（3.88±1.25）次、（4.34±1.65）次,观察组发作次数少于对照组,但差异无统计学意义（P〉0.05）。结论：孟鲁司特对婴幼儿反复病毒相关性喘息治疗及预防效果不佳。建议结合患儿更多的临床特征包括更加详细的喘息发作情况及明确的过敏信息研究婴幼儿反复喘息,可能有助于找到孟鲁司特治疗有效的喘息表型。

Clinical Observation of Montelukast for Treatment of Recurrent Wheezing in Infants and Young Children

Objective： To investigate the clinical efficacy of the treatment for recurrent wheezing in infants and young children by montelukast. Methods： One hundred children from 6 to 24 months of age with ≥2 episodes of wheezing with respiratory tract illness in the previous year were divided into two groups randomly, the treatment group （51 cases） and the control group （49 cases）, conventional medical treatment were given to both groups. Montelukast was appended in the treatment group, 4 mg, daily, 3 months. The time of follow-up was over 1 year. Results： In the treatment group and the control group, the time of cough disappearance were （7.58±2.46） d and （8.35 ±2.61 ） d, respectively ; asthma disappearance time were （5.5± 1.2 ） d and （6.0± 1.4 ） d, respectively. There were no significant differences （P〉0.05）. The differences in patients with recurrence of wheeze within one year between the two groups were not significant （ P 〉 0.05 ）. Conclusions： In this study, montelukast did not improve respiratory symptoms of recurrent wheezing in infants and young children.