Allergy, Respiratory Medicine Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Allergy Asthma Proc. 2010 Mar-Apr;31(2):147-53. doi: 10.2500/aap.2010.31.3324.
This study was designed to evaluate the effect of once-daily montelukast therapy on the clinical progress and the cytokine profile of patients with acute viral bronchiolitis. A randomized, double-blind, placebo-controlled trial included 85 patients (mean age, 3.5 +/- 2.35 months), clinically diagnosed as first-episode acute bronchiolitis in addition to 10 healthy controls of matched age and sex. Patients were randomly assigned to receive either montelukast (4-mg sachets; n = 47) or placebo (n = 38) daily from the time of admission until discharge. The primary outcome measure was the length of hospital stay (LOS), and clinical severity scores (CSs) and changes in plasma levels of interferon gamma and interleukin-4 were secondary outcomes. LOS for the montelukast group was found to be significantly lower than that of the placebo group (p < 0.05). This effect was also found at nonsignificant levels among patients with a positive family history of asthma or allergy. Moreover, cases receiving montelukast showed lower CSs all through the hospital stay that were significant in the first 24 hours (p < 0.05). Montelukast is probably of benefit as an episodic modifier in infants with acute viral bronchiolitis.
本研究旨在评估每日一次孟鲁司特治疗对急性病毒性细支气管炎患者临床进展和细胞因子谱的影响。一项随机、双盲、安慰剂对照试验纳入了 85 例（平均年龄 3.5 +/- 2.35 个月）患者，这些患者除了 10 例年龄和性别相匹配的健康对照者外，还被临床诊断为首次发作的急性细支气管炎。患者随机分为孟鲁司特（4 毫克小袋；n = 47）或安慰剂（n = 38）组，从入院开始每天接受治疗直至出院。主要结局指标为住院时间（LOS），次要结局指标为临床严重程度评分（CSs）和血浆干扰素γ和白细胞介素-4水平的变化。孟鲁司特组的 LOS 明显低于安慰剂组（p < 0.05）。在具有哮喘或过敏家族史阳性的患者中，也观察到这种效果，但没有达到统计学显著性。此外，接受孟鲁司特治疗的病例在整个住院期间的 CSs 均较低，在最初 24 小时内具有显著性（p < 0.05）。孟鲁司特可能对急性病毒性细支气管炎婴儿的发作性修饰有益。
