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目的探讨孟鲁司特对哮喘患儿血、尿白三烯的影响。方法选择2007年5至12月在中国医科大学盛京医院小儿呼吸内科病房及PICU住院的哮喘急性中重度发作患儿40例,采用随机数字表法随机分为两组:(1)孟鲁司特组:接受常规治疗及孟鲁司特治疗。(2)常规治疗组:只接受常规治疗。哮喘急性发作治疗前后分别留取血及尿标本,待测白三烯。另取同期儿保体检健康儿童19例作为健康对照组。结果 (1)在哮喘急性发作期,孟鲁司特组与常规治疗组白三烯质量浓度差异无统计学意义(P>0.05);在哮喘症状缓解期,孟鲁司特组白三烯质量浓度明显低于常规治疗组(P<0.01);两组白三烯水平下降值差异有统计学意义(P<0.05)。(2)健康对照组血白三烯C4(LTC4)为(105.87±17.38)ng/L,尿白三烯E4(LTE4)为(91.76±33.73)ng/L;在哮喘症状缓解期,孟鲁司特组血LTC4(152.74±31.50)ng/L,尿LTE4(129.35±42.76)ng/L;常规治疗组患儿血LTC4(188.95±39.31)ng/L,尿LTE4(170.67±52.86)ng/L。3组血与尿白三烯质量浓度差异均有统计学意义(P<0.01)。(3)血与尿白三烯质量浓度无相关性(r=0.251,P>0.05)。(4)孟鲁司特组患儿咳嗽、肺部啰音持续时间和住院时间均较常规治疗组缩短,差异有统计学意义(P<0.05)。结论孟鲁司特能降低哮喘患儿白三烯,缩短哮喘症状、体征持续时间,有助于控制哮喘发作。
Objective To investigate the effect of montelukast on blood and urinary leukotrienes in children with asthma. Methods From May 2007 to May 2007, 40 children with acute or moderate asthma exacerbation who were hospitalized in Pediatric Respiratory Medicine Ward and PICU of Shengjing Hospital of China Medical University were randomly divided into two groups using random number table: (1) Special group: receive routine treatment and montelukast treatment. (2) conventional treatment group: only accept conventional treatment. Before and after the treatment of acute exacerbation of asthma, blood and urine samples were collected and tested for leukotriene. Another take the same period the health check-up of 19 healthy children as a healthy control group. Results (1) There was no significant difference in the concentration of leukotrienes between the montelukast group and the conventional treatment group during the acute exacerbation of asthma (P> 0.05). In the remission stage of asthma, the levoterpen in the montelukast group (P <0.01). The difference of leukotriene level between the two groups was statistically significant (P <0.05). (2) The levels of leukotriene C4 (LTC4) in healthy controls were (105.87 ± 17.38) ng / L and those of LTE4 were (91.76 ± 33.73) ng / L; The blood levels of LTC4 and LT4 in patients in the conventional treatment group were significantly lower than those in the control group (LTC4, LTC4, 152.44 ± 31.50 ng / L, and LTE4, 129.35 ± 42.76 ng / L. The differences of blood and urine leukotriene between the three groups were statistically significant (P <0.01). (3) There is no correlation between blood and urinary leukotriene (r = 0.251, P> 0.05). (4) The incidence of cough, duration of pulmonary rales and hospital stay in montelukast group were shorter than those in the conventional treatment group, with significant difference (P <0.05). Conclusion Montelukast can reduce leukotrienes in children with asthma, shorten the symptoms of asthma, duration of signs, and help control the asthma attack.