Abstract: 【Objective】 To explore the effect of montelukast on the treatment of airway inflammation in the bronchiolitis after respiratory syncytial virus (RSV) infection by studying the clinical manifestations and change of serum concentration of inflammatory cellular factors including interleukin-5(IL-5) and eotaxin. 【Methods】 88 infants with bronchiolitis caused by primary infection of RSV associated with atopy (1 eczeca,family asthmatic history ) were recruited in the study and they were randomly divided into two groups, forty cases were selected as the control group treated with conventional therapy. 48 cases were treated with montelukast in addition to conventional therapy.Blood samples were collected on the first day on admission before treatment and recovery phase of the disease. Follow-up was done to observe recurrence for 3 months. 【Results】 IL-5 and Eotaxin level in patients during acute phase of the desease were significiantly higher than those during recovery phase, the level of Il-5 and eotaxin were decreased distinctly by montelukast.moreover . The differences in patients with reccurrence of wheeze between trial groups and control groups were significant. 【Conclusion】 Montelukast may decrease the serum concentrations of IL-5, eotaxin and control airway inflammation in the bronchiolitis after RSV, it may play a role in the prevention of recurrence attacks of wheeze after bronchiolitis.

Key words: montelukast, respiratory syncytial virus, bronchiolitis, interleukin-5, eotaxin

摘要： 【目的】 通过检测炎症因子白介素-5(IL-5)和嗜酸粒细胞趋化蛋白(eotaxin)的变化及临床表现,探讨孟鲁司特对呼吸道合胞病毒(respiratory syncytial virus,RSV)毛细支气管炎(毛支)后气道炎症的干预作用。 【方法】 选择88例初次喘息发作的具有特应性体质的患儿作为研究对象,随机选择40例毛支患儿作为对照组予常规治疗;48例观察组在常规治疗的同时口服孟鲁司特钠。分别在急性期及恢复期检测血清IL-5及eotaxin水平的变化,门诊随访3月,观察有无喘息再次发作。 【结果】 毛支患儿急性期血清IL-5及eotaxin水平明显增高,经孟鲁司特干预后,恢复期IL-5及eotaxin水平明显下降。3个月内喘息再次发作人数情况比较,观察组与对照组相比,差异具有统计学意义。 【结论】 孟鲁司特对RSV毛支患儿炎性因子IL-5和eotaxin有下调作用,可控制毛细支气管炎后的气道炎症,对毛支后喘息的反复发作具有预防作用。

关键词: 孟鲁司特钠, 呼吸道合胞病毒, 毛细支气管炎, 白介素-5, 嗜酸粒细胞趋化蛋白