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白三烯受体拮抗剂在儿童变应性鼻炎中的临床应用专家共识(2023,广州)

Expert consensus on clinical application of leukotriene receptor antagonist in the treatment of allergic rhinitis in children (2023, Guangzhou)

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【作者】 刘文龙罗茜曾清香杨钦泰邱前辉徐睿孙悦奇杨贵唐隽洪海裕许元腾石照辉魏欣王天生孟娟杨玉成王英娄鸿飞孟粹达叶菁张立强杨艳莉安云芳陆美萍曾明王向东陈建军雍军余少卿张维天孙亚男张天虹孙娜李幼瑾刘翔李健左可军罗向前王洪田许昱喻国冻付勇叶惠平李勇许成利李华斌

【Author】 LIU Wenlong;LUO Xi;ZENG Qingxiang;YANG Qintai;QIU Qianhui;XU Rui;SUN Yueqi;YANG Gui;TANG Jun;HONG Haiyu;XU Yuanteng;SHI Zhaohui;WEI Xin;WANG Tiansheng;MENG Juan;YANG Yucheng;WANG Ying;LOU Hongfei;MENG Cuida;YE Jing;ZHANG Liqiang;YANG Yanli;AN Yunfang;LU Meiping;ZENG Ming;WANG Xiangdong;CHEN Jianjun;YONG Jun;YU Shaoqing;ZHANG Weitian;SUN Yanan;ZHANG Tianhong;SUN Na;LI Youjin;LIU Xiang;LI Jian;ZUO Kejiu;LUO Xiangqian;WANG Hongtian;XU Yu;YU Guodong;FU Yong;YE Huiping;LI Yong;XU Chengli;LI Huabin;Department of Otorhinolaryngology Head and Neck Surgery,Guangzhou Women and Children’s Medical Center;Department of Otorhinolaryngology Head and Neck Surgery&Department of Allergy,the Third Affiliated Hospital of Sun Yat-sen University;Department of Otorhinolaryngology Head and Neck Surgery,Guangdong Provincial People’s Hospital;Allergy Department of Otorhinolaryngology Hospital,the First Affiliated Hospital of Sun Yat-Sen University;Department of Otorhinolaryngology,the 7th Affiliated Hospital,Sun Yat-sen University;Department of Otorhinolaryngology,the Central Hospital of Shenzhen Longgang District;Department of Otorhinolaryngology Head Neck and Surgery,the First People’s Hospital of Foshan;Department of Otorhinolaryngology,the 5th Affiliated Hospital,Sun Yat-sen University;Department of Otorhinolaryngology Head Neck and Surgery,the First Affiliated Hospital of Fujian Medical University;Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University;Department of Otorhinolaryngology Head and Neck Surgery,Third Xiangya Hospital,Central South University;Department of Otorhinolaryngology Head and Neck Surgery,West China Hospital,Sichuan University;Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Chongqing Medical University;Department of Rhinology,the First Hospital of Zhengzhou University;Department of Otorhinolaryngology,EYE&ENT Hospital of Fudan University;Department of Otorhinolaryngology Head and Neck Surgery,China-Japan Union Hospital of Jilin University;Department of Otorhinolaryngology Head and Neck Surgery,the First Hospital Affiliated to Nanchang University;Department of Otorhinolaryngology,Qilu Hospital of Shandong University;Department of First Otorhinolaryngology,the First Affiliated Hospital of Kunming Medical University;Department of Otorhinolaryngology,the Second Hospital of Shanxi Medical University;Department of Otorhinolaryngology,the First Affiliated Hospital of Nanjing Medical University;Department of Otorhinolaryngology,Head and Neck Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology;Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University;Department of Otorhinolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology;Department of Otorhinolaryngology,the First Affiliated Hospital of Xinjiang Medical University;Department of Otorhinolaryngology Head and Neck Surgery,Tongji Hospital,Tongji University School of Medicine;Department of Otorhinolaryngology Head and Neck Surgery,Sixth People’s Hospital,Shanghai Jiao Tong University;Department of Otorhinolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Harbin Medical University;Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Harbin Medical University;Department of Otolaryngology,Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai Traditional Chinese Medicine;Department of Otorhinolaryngology,oral and maxillofacial surgery,Shanghai Children’s Medical Center;Department of Otorhinolaryngology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University;Department of Otorhinolaryngology,Head and Neck Surgery of Otorhinolaryngology Hospital,the First Affiliated Hospital of Sun Yat-Sen University;Department of Pediatric Otolaryngology,Shenzhen Hospital,Southern Medical University;Department of Allergy,Beijing Shijitan Hospital,Capital Medical University;Department of Otorhinolaryngology,Head and Neck Surgery,Renmin Hospital,Wuhan University;Department of Otorhinolaryngology,Head and Neck Surgery,Affiliated Hospital of Guizhou Medical University;Department of Otorhinolaryngology,Head and Neck Surgery,Children’s Hospital Affiliated to Medical College of Zhejiang University;Department of Otorhinolaryngology,Guizhou Provincial People’s Hospital;Department of Otorhinolaryngology,Hangzhou First People’s Hospital;Department of Otorhinolaryngology,Head and Neck Surgery,the Second Affiliated Hospital of Guangxi Medical University;Chinese Rhinopathy Research Cooperation Group;

【通讯作者】 刘文龙;付勇;叶惠平;李勇;许成利;李华斌;

【机构】 广州医科大学附属妇女儿童医疗中心耳鼻咽喉科中山大学附属第三医院耳鼻咽喉头颈外科和变态反应(过敏)科广东省人民医院耳鼻咽喉头颈外科中山大学附属第一医院耳鼻咽喉科医院变态反应专科中山大学附属第七医院耳鼻咽喉科深圳市龙岗中心医院耳鼻咽喉科佛山市第一人民医院耳鼻咽喉头颈外科中山大学附属第五医院耳鼻咽喉科福建医科大学附属第一医院耳鼻咽喉头颈外科海南省人民医院,海南医学院附属海南医院耳鼻咽喉头颈外中南大学湘雅三医院耳鼻咽喉头颈外科四川大学华西医院耳鼻咽喉头颈外科重庆医科大学附属第一医院耳鼻咽喉头颈外科郑州大学第一附属医院鼻科复旦大学附属眼耳鼻喉科医院耳鼻喉科吉林大学中日联谊医院耳鼻咽喉头颈外科南昌大学第一附属医院耳鼻咽喉头颈外科山东大学齐鲁医院耳鼻咽喉科昆明医科大学第一附属医院耳鼻喉一科山西医科大学第二医院耳鼻咽喉科南京医科大学第一附属医院耳鼻咽喉科华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科首都医科大学附属北京同仁医院耳鼻咽喉头颈外科华中科技大学同济医学院附属协和医院耳鼻咽喉科新疆医科大学第一附属医院耳鼻咽喉科同济大学附属同济医院耳鼻咽喉头颈外科上海交通大学附属第六人民医院耳鼻咽喉头颈外科哈尔滨医科大学附属第二医院耳鼻咽喉头颈外科哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科上海中医药大学附属光华中西医结合医院耳鼻咽喉头颈外科上海交通大学医学院附属上海儿童医学中心耳鼻喉口腔颌面外科中山大学孙逸仙纪念医院耳鼻咽喉科中山大学附属第一医院耳鼻咽喉科医院耳鼻咽喉头颈外科南方医科大学深圳医院儿童耳鼻咽喉科首都医科大学附属北京世纪坛医院变态反应科武汉大学人民医院耳鼻咽喉头颈外科贵州医科大学附属医院耳鼻咽喉头颈外科浙江大学医学院附属儿童医院耳鼻咽喉头颈外科贵州省人民医院耳鼻咽喉科浙江大学医学院附属杭州市第一人民医院耳鼻咽喉科广西医科大学第二附属医院耳鼻咽喉头颈外科中国鼻病研究协作组

【摘要】 半胱氨酸白三烯(CysLT)是免疫细胞合成和分泌的炎性介质,与细胞膜上的受体结合发挥生物学效应,参与多种过敏性疾病的发病。抗白三烯药物有两类:CysLT1受体拮抗剂(LTRA)和白三烯合成抑制剂,前者与CysLT1受体结合,从而干扰过敏性炎症的发生。LTRA在儿童过敏性疾病的治疗中广泛应用,但仍存在质疑与挑战。因此,中国鼻病研究协作组召集国内中青年鼻科专家,制订了LTRA治疗儿童变应性鼻炎专家共识,旨在指导儿童变应性鼻炎临床诊疗工作。目前国内外指南均推荐LTRA作为儿童变应性鼻炎治疗的一线药物。儿童对孟鲁司特一般耐受性良好,总体不良反应发生率与安慰剂相似,对神经精神影响的研究尚无统一意见,临床医师应意识到神经精神事件的潜在风险,在开具相应处方时注意权衡利弊。

【Abstract】 Cysteine leukotriene(CysLT) is an inflammatory medium synthesized and secreted by immune cells. It is involved in many allergic diseases by binding with cell membrane receptors to exert biological effects. There are two classes of anti-leukotriene drugs: CysLT1 receptor antagonists(LTRA), which bind to CysLT1R and thus interfere with the occurrence of allergic inflammation, and leukotriene synthesis inhibitors. LTRA has been widely used in the treatment of allergic diseases in children, but there are still concerns and challenges. Therefore, the Chinese Rhinopathy Research Collaboration Group convened young and middle-aged rhinology experts in China to develop an expert consensus and guide the treatment of allergic rhinitis in children with LTRA. At present, both domestic and foreign guidelines recommend LTRA as the first-line medicine for the treatment of allergic rhinitis in children. Montelukast is generally well tolerated in children, and the overall incidence of adverse reactions is similar to placebo. There is no consensus on the neuropsychiatric effects of Montelukast. Clinicians should be aware of the potential risk of neuropsychiatric events, and consider benefits and risks when prescribing LTRA.

【基金】 国家重点研发计划(2022YFC2504100);国家自然科学基金(81970864、82171104、82271139、81970850、82271138、81725004、81970861、82271142、82371113、82171104);国家自然科学基金青年基金(82101201);广东省自然科学基金(2022A1515012617)
  • 【文献出处】 中国眼耳鼻喉科杂志 ,Chinese Journal of Ophthalmology and Otorhinolaryngology , 编辑部邮箱 ,2024年03期
  • 【分类号】R765.21
  • 【下载频次】51
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