【摘要】 目的观察白三烯(LTs)受体拮抗剂(孟鲁司特钠)在儿童腺样体肥大(AH)治疗中的疗效,探讨LTs受体拮抗剂用于治疗儿童AH的临床可行性。方法收集2007年1月至2010年12月在广州医学院第二附属医院就诊的上气道咳嗽综合征合并腺样体肥大和(或)并有过敏性鼻炎的患儿,分为观察组116例和对照组52例,各组均予对症治疗及按需使用抗生素,在此基础上观察组给予LTs受体拮抗剂(孟鲁司特钠)治疗16周。观察治疗前后各组患儿咳嗽持续天数、呼吸相关睡眠障碍症状指标评分及腺样体/鼻咽比值(A/N比值)的改变。结果治疗16周后:(1)观察组呼吸相关睡眠障碍症状指标评分、咳嗽天数,A/N比值分别由(12.31±2.58)分、(52.59±11.87)d、0.77±0.04下降至(5.68±3.30)分、(19.99±11.14)d、0.64±0.07,治疗前后差异有统计学意义(P<0.001)。对照组治疗前后上述各指标差异无统计学意义(P>0.05)。观察组与对照组在治疗前上述各指标差异无统计学意义,治疗后各指标间差异有统计学意义(P<0.001);(2)对观察组中的上气道咳嗽综合征合并单纯AH及AH合并过敏性鼻炎(AH-AR)患儿进行统计学分析发现,两组上述各项指标治疗前差异无统计学意义,治疗后各指标间差异存在统计学意义(P<0.001)。结论孟鲁司特钠治疗儿童上气道咳嗽综合征,能减少咳嗽持续的天数,并不同程度改善各类型AH的临床症状及缩小腺样体体积,且对单纯AH疗效优于AH-AR患儿。更多还原

【Abstract】 Objective To study the clinical feasibility of therapy with leukotriene receptor antagonist,montelukast for adenoidal hypertrophy in children.Methods Children with upper respiratory cough syndrome complicated with adenoidal hypertrophy and/or allergic rhinitis were selected for the present study.The study population was divided into 2 groups:experiment group and control group.Symptomatic therapy together with antibiotics,if needed,were used for both groups,while leukotriene antagonist(Montelukast) was added to experiment group for a total of 16 weeks.The change of duration of cough symptoms of respiratory related sleep disorder score and adenoid/pharyngeal ratio(A/N ratio) were measured.Results After 16 weeks’ therapy:(1) Sleep disorder score,number of days with cough and the ratio of A/N reduced from(12.31±2.58) ,(52.59±11.87) d,(0.77±0.04) to(5.68±3.30) ,(19.99±11.24) d and(0.64±0.07) respectively;the difference before and after the therapy was significant(P < 0.001) .Before and after the therapy there was no difference in the above-mentioned index in the control group(P > 0.05) .Before the therapy,there was no difference for all the above-mentioned index between the experiment group and the control group,while after the therapy,there were significant differences between the two groups.(2) Statistical analysis for those with upper respiratory cough syndrome complicated with simple adenoidal hypertrophy(AH group) and those with adenoidal hypertrophy complicated allergic rhinitis(AH-AR group) showed that there was no difference for all the above index between the two groups(P < 0.001) .Conclusion Montelukast therapy is able to reduce the number of days with cough,and improve in various degree each type of symptoms of adenoidal hypertrophy and reduced the size of the adenoid;its efficacy for simple adenoidal hypertrophy is better than that for patients with adenoidal hypertrophy complicated with allergic rhinitis.更多还原