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目的 观察孟鲁司特钠治疗轻、中度支气管哮喘(简称哮喘)并发运动诱发支气管收缩(EIB)或运动性哮喘(EIA)的治疗及预防作用。方法 采用前瞻性开放、自身治疗前、后对照的方法。选择轻、中度哮喘并运动激发试验阳性患者30例,给予孟鲁司特钠每晚10mg治疗1个月。分别于治疗前1d、治疗后3d及4周进行运动激发试验。主要观察运动后的前60min一秒钟用力呼气容积(FEV1)自基线下降的百分比时间曲线下面积(AUC0~60min),运动后FEV1最大下降程度(FEV1最低值)及自最低FEV1恢复至运动前基值5%以内所需的时间(FEV1最低值恢复时间)。结果 孟鲁司特钠治疗前1d、治疗后3d和治疗后4周,运动激发试验后AUC0~60min分别为(39±21)、(13±14)、(12±14)%·min,治疗前、后比较差异有统计学意义(P<001);FEV1最低值分别为(18±06)、(21±06)、(23±08)L,治疗前、后比较差异有统计学意义(P<001);FEV1最低值恢复时间分别为(51±36)、(26±28)、(25±33)min,治疗前、后比较恢复时间显著缩短(P<001),并持续1个月。EIB/EIA患者孟鲁司特钠治疗前、后肺功能[FEV1、峰流速(PEFR)]均可维持接近正常且无明显变化。吸入糖皮质激素不能预防EIB/EIA。结论 孟鲁司特钠对轻度哮喘患者并发EIB/EIA疗效和预防作用显著,而且安全、快捷。
Objective To investigate the therapeutic and preventive effects of montelukast sodium on bronchial asthma (EIB) or exercise-induced asthma (EIA) complicated by mild and moderate bronchial asthma. Methods Using prospective open, self-treatment before and after the control method. Thirty patients with mild, moderate asthma and exercise-induced test were selected and montelukast sodium was administered for 10 months at a dose of 10 mg per night. Motor exercise tests were performed at 1 day before treatment, 3d and 4 weeks after treatment. Mainly observe the area under the percentage of time curve (AUC0 ~ 60min) of forced expiratory volume (FEV1) falling from baseline in the first 60min after exercise, the maximum decrease of FEV1 (the lowest of FEV1) after exercise and the recovery from the lowest FEV1 to exercise The time required for up to 5% of the previous base (FEV1 minimum recovery time). Results After treatment with montelukast sodium for 1 day, 3 days and 4 weeks after the exercise, the AUC of 60 to 60 minutes after exercise challenge were (39 ± 21), (13 ± 14) and (12 ± 14)% min, respectively The difference between before and after treatment was statistically significant (P <0.001). The lowest FEV1 values were (18 ± 06), (21 ± 06) and (23 ± 08) P <0.001). The recovery time of FEV1 was (51 ± 36), (26 ± 28) and (25 ± 33) min respectively. The recovery time was significantly shorter before and after treatment (P <001) month. EIB / EIA patients with montelukast sodium before and after treatment, pulmonary function [FEV1, peak flow velocity (PEFR]] can be maintained close to normal and no significant change. Inhaled glucocorticoids do not prevent EIB / EIA. Conclusion Montelukast sodium is effective and effective in preventing and treating EAB / EIA complicated with mild asthma, and it is safe and fast.