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孟鲁司特钠联合布地奈德对合并过敏性鼻炎和哮喘儿童肺功能、血清IgE水平及嗜酸性粒细胞百分比的影响

Effects of montelukast sodium combined with budesonide on pulmonary function, serum IgE levels, and EOS percentage in children with comorbid allergic rhinitis and asthma.

作者信息

Guo Shasha, Cao Changxing

机构信息

Department of Pediatric Medicine, Guizhou Provincial People's Hospital Guiyang 550002, Guizhou, China.

Department of Otorhinolaryngology, Guizhou Provincial People's Hospital Guiyang 550002, Guizhou, China.

出版信息

Am J Transl Res. 2023 Dec 15;15(12):6823-6831. eCollection 2023.

Abstract

OBJECTIVE

This study was designed to determine the effects of montelukast sodium combined with budesonide on pulmonary function, serum immunoglobulin (Ig)E levels, and eosinophil (EOS) percentage in children comorbid with allergic rhinitis (AR) and asthma.

METHODS

The medical records of 114 children comorbid with AR and asthma treated in the Guizhou Provincial People's Hospital from February 2020 to September 2022 were collected and analyzed retrospectively. Among them, 54 children treated with budesonide were assigned to a control group, and the remaining 60 children treated with montelukast sodium combined with budesonide were assigned to an observation group. The efficacy was compared between the two groups. Additionally, the changes in pulmonary function, serum IgE levels, and EOS percentage were compared between the two groups before and after treatment (one month). The adverse reactions during the treatment and the recurrence of AR within 3 months were recorded. Logistics regression was conducted to analyze the risk factors affecting the efficacy in children.

RESULTS

The observation group showed a significantly higher overall response rate than the control group (P<0.05). After treatment, the observation group showed significantly higher levels of forced expiratory volume in 1 second (FEV1)%, FEV1/forced vital capacity (FVC), and peak expiratory flow (PEF) than the control group (P<0.05), and significantly lower IgE levels and EOS percentage than the control group (P<0.05). No significant difference was found between the two groups in terms of the total incidence of adverse reactions (P>0.05). According to the follow-up results of prognosis, the observation group presented a greatly lower recurrence rate of AR within 3 months than the control group (P<0.05). Multivariate logistics regression analysis showed that therapeutic regimen, IgE, and EOS were independent risk factors affecting the efficacy in the patients (P<0.05).

CONCLUSION

Montelukast sodium combined with budesonide can substantially improve the pulmonary function in children with comorbid AR and asthma, alleviate their symptoms of asthma and rhinitis, and lower the IgE level and EOS percentage. In addition, therapeutic regimen, IgE and EOS are independent risk factors affecting the efficacy in patients.

摘要

目的

本研究旨在确定孟鲁司特钠联合布地奈德对合并过敏性鼻炎(AR)和哮喘的儿童肺功能、血清免疫球蛋白(Ig)E水平及嗜酸性粒细胞(EOS)百分比的影响。

方法

回顾性收集并分析2020年2月至2022年9月在贵州省人民医院治疗的114例合并AR和哮喘的儿童病历。其中,54例接受布地奈德治疗的儿童被分配到对照组,其余60例接受孟鲁司特钠联合布地奈德治疗的儿童被分配到观察组。比较两组的疗效。此外,比较两组治疗前(一个月)和治疗后肺功能、血清IgE水平及EOS百分比的变化。记录治疗期间的不良反应及3个月内AR的复发情况。进行logistic回归分析以分析影响儿童疗效的危险因素。

结果

观察组的总有效率显著高于对照组(P<0.05)。治疗后,观察组一秒用力呼气容积(FEV1)%、FEV1/用力肺活量(FVC)及呼气峰值流速(PEF)水平显著高于对照组(P<0.05),IgE水平和EOS百分比显著低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。根据预后随访结果,观察组3个月内AR复发率显著低于对照组(P<0.05)。多因素logistic回归分析显示,治疗方案、IgE和EOS是影响患者疗效的独立危险因素(P<0.05)。

结论

孟鲁司特钠联合布地奈德可显著改善合并AR和哮喘儿童的肺功能,减轻其哮喘和鼻炎症状,降低IgE水平和EOS百分比。此外,治疗方案、IgE和EOS是影响患者疗效的独立危险因素。

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本文引用的文献

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Comorbid allergic rhinitis and asthma: important clinical considerations.变应性鼻炎与哮喘并存:重要的临床关注点。
Expert Rev Clin Immunol. 2022 Jul;18(7):747-758. doi: 10.1080/1744666X.2022.2089654. Epub 2022 Jun 19.
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Allergic rhinitis: diagnosis and management.变应性鼻炎:诊断与管理。
Br J Hosp Med (Lond). 2022 Feb 2;83(2):1-9. doi: 10.12968/hmed.2021.0570. Epub 2022 Feb 23.

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