呼出气一氧化氮检测评估吸入性糖皮质激素与口服白三烯受体拮抗剂对儿童哮喘治疗效果的研究
投稿时间:2016-10-24  修订日期:2016-11-08  点此下载全文
引用本文:马卫宁,周小建,李雅春,洪建国.呼出气一氧化氮检测评估吸入性糖皮质激素与口服白三烯受体拮抗剂对儿童哮喘治疗效果的研究[J].医学研究杂志,2017,46(6):126-129
DOI: 10.11969/j.issn.1673-548X.2017.06.032
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作者单位E-mail
马卫宁 201620 上海交通大学附属第一人民医院儿科 maweining1987@126.com 
周小建 201620 上海交通大学附属第一人民医院儿科  
李雅春 201620 上海交通大学附属第一人民医院儿科  
洪建国 201620 上海交通大学附属第一人民医院儿科  
中文摘要:目的 比较吸入性糖皮质激素(ICS)和口服白三烯受体拮抗剂(LTRAs)疗效差异以及对不同严重程度气道炎症的治疗效果,并探讨呼出气一氧化氮(FeNO)水平监测在儿童哮喘治疗中的临床意义。方法 选择2013年1月~2014年3月初次到上海市第一人民医院儿科哮喘专科门诊就诊且明确诊断为哮喘的5~14岁哮喘患儿101例,分别给予吸入布地奈德、口服孟鲁司特钠,通过治疗前后FeNO检测、肺功能检查的改变,比较吸入性糖皮质激素(ICS)和口服白三烯受体拮抗剂(LTRAs)对儿童哮喘控制治疗的效果,同时对比分析上述两种药物对处于不同FeNO水平的哮喘儿童的治疗效果。结果 吸入布地奈德组与口服孟鲁司特钠组治疗前后FeNO水平显著下降(P<0.01),FEV1占预计值百分比显著提高(P<0.01);在FeNO水平增高的哮喘患儿中,吸入性糖皮质激素组FeNO水平的降低以及FEV1占预计值百分比的提高比口服白三烯受体拮抗剂组明显(P<0.05);在FeNO水平正常的哮喘患儿中,吸入布地奈德组和口服孟鲁司特钠组治疗后FEV1占预计值百分比显著提高(P<0.01),两组间差异无统计学意义(P>0.05);口服孟鲁司特钠组治疗后FeNO水平显著下降(P<0.01),而吸入布地奈德组治疗后FeNO水平无明显下降(P>0.05)。结论 吸入性糖皮质激素和口服白三烯受体拮抗剂均能有效治疗儿童轻中度持续性哮喘;动态随访FeNO水平,有助于评估哮喘的控制情况和指导哮喘治疗药物吸入性糖皮质激素和口服白三烯受体拮抗剂的应用。
中文关键词:支气管哮喘  呼出气一氧化氮  吸入性糖皮质激素  白三烯受体拮抗剂
 
Fractional Exhaled Nitric Oxide Test for Assessment of Therapeutic Effect of Children With Asthma Treated With Inhaled Corticosteroids and Oral Leukotriene Receptor Antagonists
Abstract:Objective To Compare of inhaled corticosteroids (ICS) and oral leukotriene receptor antagonist (LTRAs) curative effect and treatment effect on airway inflammation of different severity, and to explore the clinical significance of monitoring the level of FeNO in the treatment of asthma in children. Methods From January 2013 to March 2014, 101 cases of children aged 5-14 years with asthma diagnosed as asthma were enrolled in the Shanghai First People's Hospital pediatric asthma clinic.They were given inhaled budesonide, (ICS) and oral leukotriene receptor antagonist (LTRAs), and the effects of the above two drugs therapeutic effect were compared by the changes of pulmonary function tests before and after treatment. At the same time, the therapeutic effects of the above two drugs on asthmatic children at different FeNO levels are compared. Results FeNO levels were significantly decreased and FEV1/pred was increased after treatment with inhaled corticosteroids group and oral leukotriene receptor antagonist group(P<0.01). In the patients with elevated FeNO levels, the levels of FeNO were significantly decreased and FEV1/pred was significantly increased in inhaled budesonide group and oral montelukast group(P<0.01). In the patients with normal FeNO levels, the level of FeNO was decreased significantly in oral montelukast group(P<0.01). FeNO levels decreased degree had no statistical significance in the inhaled budesonide group (P>0.05). FEV1/pred increased degree was more significant than pre-treatment. Degree of change between two group had no significance(P<0.01). Conclusion Inhaled corticosteroids and oral leukotriene receptor antagonists can effectively treat children with mild to moderate persistent asthma. Dynamic follow FeNO levels, and guidance to help assess asthma control of asthma therapy with inhaled corticosteroids and oral leukotriene receptor antagonists.
keywords:Bronchial asthma  Fractional exhaled nitric oxide  Inhaled corticosteroids  Leukotriene receptor antagonists
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