【摘要】 目的:比较布地奈德（BUD）和孟鲁司特（LTM）对儿童轻度持续哮喘应用途径与药物的疗效。方法:60名轻度持续哮喘患儿,平均年龄（7.66±2.28）岁。随机分为BUD组和LTM组。LTM组:男15例,女15例,口服孟鲁司特5 mg,每晚1次;BUD组:男16例,女14例,吸入布地奈德200μg,每天2次。疗程8周。治疗前后,分别检测患儿第1秒用力呼气容积（FEV₁）、第1秒用力呼气容积占肺活量比率（FEV₁/FVC）、组胺支气管激发试验（PD20）、痰嗜酸性粒细胞计数（Eos%）,并作临床症状评分。结果:BUD组:治疗后日间症状评分（0.13±0.18）和夜间症状评分（0.093±0.28）较治疗前日间症状评分（1.26±0.51）和夜间症状评分（0.32±0.41）显著降低（P<0.01,P<0.05）;治疗后FEV₁（1.61±0.35）L较治疗前（1.42±0.46）L显著提高（P<0.01）;治疗后PD20（3.19±2.17）μmol较治疗前（1.68±1.74）μmol显著提高（P<0.01）,治疗后Eos%（6.39±6.63）%较治疗前（22.2±23.6）%显著降低（P<0.01）。LTM组:疗后日间症状评分（0.19±0.26）和夜间症状评分（0.12±0.22）较治疗前日间症状评分（1.17±0.27）和夜间症状评分（0.48±0.38）显著降低（P<0.01,P<0.05）;治疗后FEV₁（1.36±0.31）L与治疗前（1.33±0.36）L差异无显著性（P=0.291）;治疗后PD20（2.87±1.75）μmol较治疗前（1.9±1.79）μmol显著提高（P<0.01）;治疗后Eos%（7.29±8.24）%较治疗前（12.17±14.47）%差异无显著性（P=0.726）。结论:吸入布地奈德和口服孟鲁司特均可有效地改善儿童哮喘的临床症状,降低气道高反应。但在改善肺功能,减轻气道炎症方面,布地奈德优于孟鲁司特。更多还原

【Abstract】 Objective:To evaluate the efficacy of Budesonide（BUD）and Montelukast（LTM）in children with mild persistent asthma.Methods:60 children with mild persisitent asthma,aged（7.66±2.28）,were randomly divided into two groups and treated with inhaled BUD（200μg）twice daily（n=30,M/F:16/14）or oral LTM（5 mg）once daily（n=30,M/F:15/15）.The outcomes included daytime symptom scores,night-time symptom scores,FEV₁, FEV₁/FVC,bronchial provocation testing with histamine(provocative dose caused a 20%fall in FEV₁（PD20）,and suptum Eosinophil cell count（Eos%）.Results:Group Bud:Afer 8-week treatment,the daytime and night-time symptom scores decreased significantly in group BUD（daytime symptom score changed from 1.26±0.51 to 0.13±0.18,P<0.01;and night-time symptom score from 0.32±0.41 to 0.093±0.28,P<0.05）;FEV₁ improved greatly after treament from（1.42±0.46）L to（1.61±0.35）L,（P<0.01）;PD20 were improved from（1.68±1.74）μmol to（3.19±2.17）μmol（P<0.01）;Eos%decreased significantly from（22.2±23.6）%to（6.39±6.63）%（P<0.01）.Group LTM:daytime symptom score changed from 1.17±0.27 to 0.19±0.26,P<0.01;and night-time symptom score from（0.48±0.38）to（0.12±0.22）（P<0.05）;FEV₁ improved slightly from（1.33±0.36）L to（1.36±0.31）L,but the difference was not significant（P=0.291）;PD20 were improved from（1.9±1.79）μmol to（2.87±1.75）μmol significantly（P<0.01）;EOS%decreased slightly from（12.17±14.47）%to （7.29±8.24）%,but the difference was not significant（P=0.726）.Conclusion:This study demonstrates that both LTM and inhaled BUD can reduce symptom scores and airway hyperresponsiveness in children with mild persistent asthma,but in terms of additional attenuation of airway inflammation and improvement of patient’s pulmonary function, BUD is superior to LTM.更多还原