孟鲁司特钠联合布地奈德对哮喘患儿血清IgE水平及肺功能的影响

摘要

目的：分析孟鲁司特钠联合布地奈德对哮喘患儿血清免疫球蛋白 E（immunoglobulin E，IgE）及肺功能的影响，探讨其临床应用价值。方法选取本院2013年3月至2016年3月收治的164例哮喘患儿为研究对象。按照随机数表法将其分为观察组和对照组，每组各82例。所有患儿均给予布地奈德雾化吸入治疗及常规解痉、祛痰综合治疗，观察组患儿口服孟鲁司特钠。比较两组患儿临床疗效、不良反应发生情况、血清 IgE 水平和肺功能变化情况，明确联合用药方案的疗效与安全性。结果164例患儿均顺利完成治疗。观察组患儿临床治疗总有效率为92.68%（76/82），显著高于对照组[73.17%（60/82）]（P ＜0.05）。观察组患儿不良反应发生率为3.66%（3/82），对照组为4.88%（4/82），两组比较差异无显著性（χ2＝0.275，P ＞0.05）。治疗后两组患儿血清 IgE 水平较治疗前均显著降低（P ＜0.05），第一秒用力呼气量（forced expiratory volume in first second，FEV1）、用力肺活量（forced vital capacity，FVC）及呼气流量峰值（peak expiratory flow，PEF）较治疗前均显著升高（P ＜0.05），观察组患儿上述指标水平变化较对照组更显著（P ＜0.05）。结论孟鲁司特钠联合布地奈德能够显著降低哮喘患儿血清 IgE 水平，改善肺功能，并在保证治疗安全性的基础上有效提高临床疗效。%Objective To analyze the effect of montelukast combined with budesonide on serum immuno-globulin E (IgE) and pulmonary function in children with asthma, to explore its clinical application value. Method 164 cases of children with asthma in our hospital from March 2013 to March 2016 were randomly divided into observation group and control group, 82 cases in each group. They were treated with budesonide inhalation therapy and routine spasmolysis, expectorant treatment, observation group children were treated with montelukast orally. The clinical efficacy, adverse reactions and changes of serum IgE level and pulmonary function betwee the two groups were compared, and the efficacy and safety of the combined drug regimen were defined. Result 164 cases of children were successfully completed 2 months of treatment. The total effective rate of observation group [92.68% (76/82)] was higher than control group [73.17% (60/82)] (P < 0.05). The incidence of adverse reactions of observation group was 3.66% (3/82), control group was 4.88% (4/82), the incidence of adverse reactions between the two groups was not statistically significant (χ2 = 0.275, P >0.05). After treatment, the serum levels of IgE in the two groups were decreased, FEV1, FVC and PEF were all increased, and the changes of observation group was more obvious, the differences were statistically significant (P < 0.05). Conclusion Montelukast combined with budesonide can significantly improve the level of serum IgE and lung function in children with asthma, and on the basis to ensure the safety of the treatment on effectively improve the clinical curative effect, which is of positive significance to the improvement of symptoms.