目的 探讨甲泼尼龙琥珀酸钠联合孟鲁司特钠治疗小儿支气管哮喘的疗效。方法 回顾性分析106例支气管哮喘患儿的临床资料，将54例用甲泼尼龙琥珀酸钠联合孟鲁司特钠治疗的患儿纳入A组，52例用孟鲁司特钠治疗的患儿纳入B组，2组均治疗10d，比较2组患儿治疗前后的临床症状积分、气道反应、肺功能、炎性因子水平以及不良反应发生率。结果 治疗10d后，A组患儿的总有效率为94。44％，高于B组的80。77％(P＜0。05);A组患儿的日间临床症状积分和夜间临床症状积分均低于B组(P＜0。05);A组的气道反应指标气道峰压(peak airway pressure，PIP)、气道阻力(air way resistance，Raw)均低于B组，动态顺应性(dynamic lung compliance，Cdyn)水平高于 B 组;A组的肺功能指标氧合指数(oxygenation index，OI)、用力肺活量(forced vital ca-pacity，F VC)、第1秒用力呼气容积(forced expiratory volume in one second，FEV1)均高于B组(P＜0。05);A组的γ干扰素(inter-feron-y，IFN-y)水平高于 B 组，白细胞介素-4(interleukin-4，IL-4)、白细胞介素-33(interleukin-33，IL-33)水平均低于 B 组(P＜0。05);A组治疗期间不良反应发生率(7。41％)与B组(7。69％)比较差异无统计学意义(P＞0。05)。结论 甲泼尼龙琥珀酸钠联合孟鲁司特钠治疗小儿支气管哮喘，可有效控制和缓解患儿的哮喘症状，改善患儿的气道反应，调节免疫平衡，促进肺功能恢复。
Effect of methylprednisolone sodium succinate combined with montelukast sodium in the treatment of children with bronchial asthma
Objective To explore the clinical effect of methylprednisolone sodium succinate combined with montelukast sodium in the treatment of children with bronchial asthma.Methods A retrospective analysis was performed on the clinical data of 106 children with bronchial asthma.54 cases treated with methylprednisolone sodium succinate combined with montelukast sodium were included in group A,52 cases treated with montelukast sodium were included in group B.The both groups were treated for 10 days.The scores of clinical symptoms,airway response,lung function,the levels of inflammatory factors and the incidence of adverse reactions were compared between the 2 groups.Results After 10 days of treatment,the total response rate of group A was higher than that of group B(94.44％vs.80.77％,P＜0.05).The scores of daytime/nighttime clinical symptoms in group A were lower than those in group B(P＜0.05).The levels of peak airway pressure(PIP)and airway resistance(Raw)in group A were lower than those in group B,while the level of dynamic lung compliance(Cdyn)was higher than that in group B.The levels of oxygenation index(OI),forced vital capacity(FVC)and forced expiratory volume in one second(FEV1)in group A were higher than those in group B(P＜0.05).The level of interferon-y(IFN-y)in group A was higher than that in group B,while the levels of interleukin-4(IL-4)and interleukin-33(IL-33)were lower than those in group B(P＜0.05).There was no significant difference in the incidence of adverse reactions between group A and group B during treatment(7.41％vs.7.69％,P＞0.05).Conclusion Methylprednisolone sodium succinate combined with montelukast sodium can effectively control or alleviate asthma,improve airway response,regulate immune balance and promote the recovery of lung function in children with bronchial asthma.
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