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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。
Objective: To observe the clinical efficacy of montelukast in the treatment and prevention of recurrent virus-associated wheeze in infants and young children. Methods: 100 children with wheezing recurrent episodes of recurrent viral associated wheeze were randomly divided into observation group (n = 51) and control group (n = 49). Both groups were given anti-inflammatory, antispasmodic, anti-infection and budesonide suspension, bronchodilator atomization and other conventional treatment, if necessary, given suction treatment. Observation group in the acute phase that montelukast plus 4 mg / time, 1 / d orally, cured and then continue to take 3 months after discharge, the control group after discharge without any treatment. All children were followed up for 1 year. Results: (1) The disappearance time of cough in observation group and control group were (7.58 ± 2.46) days and (8.35 ± 2.61) days respectively, and the disappearance time of asthma was (5.5 ± 1.2) days and (6.0 ± 1.4) days respectively (P> 0.05). (2) The numbers of wheezing episodes in the observation group and the control group were (3.88 ± 1.25) and (4.34 ± 1.65), respectively, one year after discharge. The number of attacks in the observation group was small In the control group, but the difference was not statistically significant (P> 0.05). CONCLUSION: Montelukast is not effective in recurrent virus-related wheezing and prevention in infants and young children. It is suggested that combined with more clinical features in children, including more detailed episodes of wheezing and definite allergy information, repeated wheezing studies in infants and young children may help find montelukast-effective wheeze phenotypes.