摘要
目的观察布地奈德混悬液雾化吸入联合口服孟鲁司特钠在儿童胸闷变异性哮喘(chest tightness variant asthma,CTVA)中的临床疗效及安全性分析。方法以2018年9月-2019年9月于蚌埠医学院第一附属医院临床确诊为CTVA的患儿30例为研究对象。所有患儿初诊时均完成肺功能检测和胸闷症状评分(r-ACQ),且均具备支气管激发试验阳性或支气管舒张试验阳性。给予患儿常规吸入布地奈德混悬液和口服孟鲁司特钠,分别于治疗后2~4周复诊。对患儿治疗前、治疗后的肺功能主要指标[1秒用力呼气量(FEV1),1秒率(FEV1/FVC%),最大呼气流速(PEF),用力呼气25%、50%、75%肺活量时的呼气峰流速(FEF25、FEF50、FEF75)、最大呼气中期流量(MMEF)]的差异进行比较分析,并随访患儿临床症状缓解情况、r-ACQ评分值变化及不良反应发生情况。结果 CTVA患儿治疗后胸闷症状缓解率为93.3%,且经治疗后患儿的r-ACQ值较治疗前降低,这与临床症状缓解情况相符。患儿治疗后2~4周肺功能指标与治疗前比较,FEV1(F=3.623,P=0.031)、FEV1/FVC%(F=3.188,P=0.046)、PEF(F=4.506,P=0.014)、FEF25(F=8.518,P<0.001)、FEF50(F=9.794,P<0.001)、FEF75(F=8.736,P<0.001)、MMEF(F=8.923,P<0.001)差异有统计学意义(均P<0.05)。患儿在治疗期间未见明显不良反应发生。结论布地奈德混悬液联合孟鲁司特钠可有效缓解CTVA患儿的临床症状,且未见明显不良反应。
Objective To observe the clinical efficacy and safety of budesonide suspension atomized inhalation combined with oral montelukast sodium in children with chest tightness variant asthma(CTVA). Methods Thirty children with CTVA clinically diagnosed in the First Affiliated Hospital of Bengbu Medical College from September 2018 and September 2019 were enrolled. All children completed pulmonary function tests and chest tightness scores(r-ACQ) at the initial diagnosis, and all had positive bronchial challenge test or positive bronchodilator test. The children were routinely treated with inhaled budesonide suspension and/or oral montelukast sodium and revisited 2-4 weeks after treatment. The main indicators of pulmonary function before and after treatment of children [1 second forced expiratory volume(FEV1), rate of 1 second(FEV1/FVC%), maximum expiratory flow rate(PEF), forced exhalation 25%, 50%, 75% vital capacity peak expiratory flow rate(FEF25, FEF50, FEF75), maximum expiratory flow rate(MMEF)] were analyzed. The clinical symptoms, r-ACQ scores and the occurrence of adverse reactions were followed up. Results The remission rate of chest tightness after treatment was 93.3%, and the r-ACQ score of chest tightness after treatment was lower than that before treatment, which was consistent with the remission of clinical symptoms. After 2-4 weeks of treatment, the lung function indexes of the children were compared with before treatment: FEV1(F=3.623, P=0.031), FEV1/FVC%(F=3.188, P=0.046), PEF(F=4.506, P=0.014), FEF25(F=8.518, P<0.001), FEF50(F=9.794, P<0.001), FEF75(F=8.736, P<0.001), and MMEF(F=8.923, P<0.001). No obvious adverse reactions occurred during the treatment. Conclusion Budesonide suspension combined with montelukast sodium can effectively alleviate the clinical symptoms of children with CTVA, and no obvious adverse reactions.
作者
马莉娟
周瑞
王娴娴
吴令琴
单子鸿
王舒颖
杨君
MA Li-juan;ZHOU Rui;WANG Xian-xian;WU Ling-qin;SHAN Zi-hong;WANG Shu-ying;YANG Jun(Department of Pediatrics,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)
出处
《中华全科医学》
2020年第6期899-901,905,共4页
Chinese Journal of General Practice
基金
国家卫计委医药卫生科技项目(W2016EWAH06)
蚌埠医学院第一附属医院领先新技术项目基金(2019014)。
关键词
胸闷变异性哮喘
布地奈德混悬液
孟鲁司特钠
疗效
儿童
Chest tightness variant asthma
Budesonide suspension
Montelukast sodium
Efficacy
Child
作者简介
通信作者:周瑞,E-mail:1176034941@qq.com。
