Department of Pediatric Endocrinology, Dörtçelik Children's Hospital, Bursa, Turkey.
Department of Pediatrics, Faculty of Medicine, Atilim University, Ankara, Turkey.
Pediatr Pulmonol. 2021 Jul;56(7):1931-1937. doi: 10.1002/ppul.25394. Epub 2021 Apr 12.
In chronic asthma treatment, leukotriene receptor antagonists have been recommended, but it is not clear whether montelukast can be used in acute recurrent wheezing attacks in children.
To investigate the safety and effectiveness of oral montelukast in addition to standard treatment in hospitalized children aged between 6 and 72 months with acute recurrent wheezing attacks.
One hundred patients aged between 6 and 72 months who had wheezing attacks with clinical asthma scores (CAS) ≥3 and were hospitalized were included in this randomized, double-blind, placebo-controlled, parallel-group clinical trial. All the patients included in the study were given 0.15 mg/kg (maximum 5 mg) nebulized salbutamol (8 L/min and with 100% O ) with 4 h of intervals, 1 mg/kg prednisolone (maximum 5 days), nebulized ipratropium bromide (total eight doses) with 6 h of intervals. In addition to this treatment, one group received 4 mg montelukast, and the other group received a placebo. The CAS of the patients were evaluated with 4-h intervals.
Total hospital length of stay (LOS) was not different between the montelukast and placebo groups (p = 0.981). There was no statistically significant difference between the two treatment groups in terms of discharge time, CAS, and oxygen saturation (p ≥ 0.05).
Adding montelukast to standard treatment in patients hospitalized for moderate-to-severe wheezing attacks did not affect hospital LOS and CAS.
在慢性哮喘治疗中，推荐使用白三烯受体拮抗剂，但尚不清楚孟鲁司特是否可用于儿童急性复发性喘息发作。
研究在标准治疗基础上加用口服孟鲁司特治疗 6-72 月龄住院急性复发性喘息患儿的安全性和有效性。
本随机、双盲、安慰剂对照、平行分组临床试验纳入 100 例喘息发作、临床哮喘评分（CAS）≥3 分且住院的 6-72 月龄患儿。所有纳入研究的患儿均接受沙丁胺醇（8 L/min、100% O ）0.15mg/kg（最大 5mg）雾化，4 h 1 次，1mg/kg 泼尼松龙（最大 5 天），6 h 1 次雾化异丙托溴铵（共 8 剂）。在上述治疗的基础上，一组患儿加用孟鲁司特 4mg，另一组患儿加用安慰剂。4 h 评估患儿的 CAS。
孟鲁司特组和安慰剂组患儿的总住院时间（LOS）无差异（p=0.981）。两组患儿的出院时间、CAS 和血氧饱和度无统计学差异（p≥0.05）。
在因中重度喘息发作住院的患儿中，在标准治疗基础上加用孟鲁司特治疗不会影响 LOS 和 CAS。
