孟鲁司特治疗儿童咳嗽变异性哮喘临床观察.doc

孟鲁司特治疗儿童咳嗽变异性哮喘临床观察 　　[摘要] 目的:观察孟鲁司特治疗儿童咳嗽变异性哮喘的临床疗效和安全性。方法:将65例咳嗽变异性哮喘患儿随机分为治疗组32例和对照组33例,分别给予酮替酚和孟鲁司特口服,连用6个月。结果:治疗组达到临床缓解所需时间及随访半年的复发率均明显低于对照组(P90%的比率则高于对照组(P0.05),且未见明显不良反应。结论:孟鲁司特治疗儿童咳嗽变异性哮喘安全有效,可改善肺功能,降低复发率。 　　[关键词] 小儿;咳嗽变异性哮喘;孟鲁司特 　　[中图分类号] R72[文献标识码]A [文章编号]1673-7210(2009)07(c)-072-02 　　 　　Clinical therapeutic effect of Montelukast on cough variant asthma in children 　　LIN Xiaona 　　(Department of Pediatrics, Pengpai Memorial Hospital of Haifeng County, Guangdong Province, Haifeng 516400, China) 　　[Abstract] Objective: To investigate the clinical effect of montelukast in treating and preventing childrens cough variant asthma(CVA) and its safety. Methods: 65 children with CVA were randomly divided into treatment group(n=32) and control group(n=33), received orally treatment of Montelukast and Ketotifen for 6 months respectively. Results: There were significant differences in time reaching clinically relieve and rate of recurrence that follow-up for 6 months, the treatment group was lower than control group(P90% in treatment group was higher than those of control group 3, 6 months after treatment(P0.05). The treatment group had few side reaction occurred. Conclusion: Montelukast is safe and effective in treatment of childrens CVA, it can improve lung function and reduce rate of recurrence. 　　[Key words] Children; Cough variant asthma; Montelukast 　　 　　咳嗽变异性哮喘(cough variant asthma, CVA)是以咳嗽为主要表现的一种哮喘的潜在形式,占儿童慢性咳嗽的32%[1]。因其临床表现不典型,往往不易被临床医师认识而误诊,导致抗生素的滥用。2007年10月～2008年11月,我科采用白三烯受体拮抗剂孟鲁司特治疗小儿咳嗽变异性哮喘32例,取得满意效果,报道如下: 　　1 资料与方法 　　1.1 一般资料 　　本组65例均为我院儿科就诊患儿,以咳嗽持续或反复发作为主要症状,经较长期抗生素治疗无效,符合儿童支气管哮喘防治常规中咳嗽变异性哮喘的诊断标准[2]。所有病例均未按哮喘病治疗原则进行正规治疗。其中,男38例,女26例;年龄2～14岁,平均(4.8±2.9)岁;病程6～24周,平均(11.8±6.5)周。随机分为治疗组32例和对照组33例。两组间性别构成、年龄分布、病程及病情严重程度比较,均无显著性差异(P0.05),具有可比性。 　　1.2 治疗方法 　　两组均给予盐酸班布特罗溶液或片剂(商品名:帮备)5～10 mg每天1次,睡前服用,至症状体征消失后停用。在此基础上,对照组给予酮替酚片0.5～1.0 mg/次,每12小时1次口服;治疗组则给予孟鲁司特咀嚼片(商品名:顺尔宁),3～5岁4 mg,6～14岁5 mg,每晚顿服。两组均连服6个月。观察临床缓解所需时间,治疗3个月及6个月时呼气峰流速(PEF)预计值90%的比率。