| 摘要: |
| 目的:观察左西替利嗪(LCZ)治疗儿童变应性鼻炎并发过敏性哮喘的临床效果及安全性,为合理选用抗组胺药物提供参考。方法:选择2014年6月至2016年5月在随州市妇幼保健院住院的258例变应性鼻炎并发过敏性哮喘急性发作的患儿为研究对象,采用随机数字表法分为LCZ组、地氯雷他定(DLT)组和安慰剂(PLB)组各86例。三组患儿分别口服LCZ溶液0.250 mg/kg、DLT糖浆0.125 mg/kg和5%葡萄糖溶液0郾500 mL/kg,每晚1次,同时根据病情严重程度给予糖皮质激素、支气管舒张剂、白三烯调节剂、呼吸支持和抗感染等治疗。于治疗前和治疗后第1天、第7天、第14天、第28天时记录三组患儿变应性鼻炎表现、呼吸系统症状和体征并进行临床评分,比较静脉血嗜酸粒细胞(EOS)计数和血清总IgE(TIgE)水平、呼气峰流速/预计值(PEF/PDV)和第1秒用力呼气量/用力肺活量(FEV1/FVC)、血气分析结果等,观察药物不良反应发生情况。结果:LCZ组、DLT组和PLB组患儿各失访7例、5例和8例,纳入研究试验者LCZ组79例、DLT组81例、PLB组78例。入院时三组患儿性别、年龄、体质量等一般资料比较差异无统计学意义(P>0.05)。三组患儿治疗第1天时临床评分均下降,PEF/PDV和FEV1/FVC改善,血气分析好转,治疗前后比较差异有统计学意义(P<0.05);治疗第7天和第14天时临床评分、EOS计数、TIgE水平、PEF/PDV、FEV1/FVC、血气分析结果等三组间及组间两两比较差异均有统计学意义(P<0.05)。三组不良反应较少,且LCZ组不良反应发生率低于DLT组,差异有统计学意义(P<0.05)。结论:LCZ溶液和DLT糖浆治疗过敏反应效果较好,可有效缓解变应性鼻炎并发过敏性哮喘患儿的病情,LCZ临床疗效和安全性较DLT高。 |
| 关键词: 左西替利嗪 地氯雷他定 变应性鼻炎 过敏性哮喘 随机对照试验 |
| DOI：doi: 10.13407/j.cnki.jpp.1672-108X.2017.12.004 |
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| 基金项目: |
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| Clinical Efficacy and Safety about Levocetirizine for Treating Allergic Rhinitis Complicated with Asthma in Children |
| Wu Junchao 1, Yang Jingqing 1, Song Daobing 1, Wu Suihuan 1, Liu Houcun 1, Jiang Guangchun 1, Gong Shuwen 1, Wang Hui 2 |
| (1. Suizhou Maternal and Child Health Hospital, Hubei Suizhou 441300, China; 2. Wuhan University School of Basic Medical Sciences, Hubei Wuhan 430071, China) |
| Abstract: |
| Objective: To observe the therapeutic effect and safety about the levocetirizine (LCZ) treating children allergic rhinitis complicated with allergic asthma, and provide scientific basis for reasonable choice antihistamines. Methods: Two hundreds and fifty-eight children hospitalized with allergic rhinitis complicated with allergic asthma acute attack from June 2014 to May 2016 were selected as the research objects, using the random number table method divided these objects into LCZ group, desloratadine (DLT) group and the placebo group (PLB), 86 cases in each group, respectively with LCZ 0.250 mg/kg, DLT syrup 0.125 mg/kg and PLB 5% glucose 0.500 mL/kg one time every night. At the same time, according to the condition to give glucocorticoid, bronchial relaxation, leukotriene regulator, respiratory support and anti-infection treatment. The performance, respiratory symptoms and signs, clinical scoring of three groups of children allergic rhinitis were recorded before treatment and after treatment 1 d, 7 d, 14 d and 28 d, to compare the venous blood EOS and T IgE, PEF/PDV and FEV1/FVC, blood gas analysis, and observe the adverse drug events. Results: Because of the lost to follow-up, 79 cases, 81 cases and 78 cases in each group. There were no significant differences in gender, age, weight among the groups (P>0.05). There were statistically significant differences before and after the treatment about the PEF/PDV and FEV1/FVC, blood gas analysis after treatment 1 d in each group (P<0.05), there were statistically significant differences about the clinical scores, EOS, TIgE, PEF/PDV, FEV1/FVC, blood gas analysis after treatment 7 d and 14 d (P<0.05), and the LCZ group was lower than the DLT group on the rate of adverse reactions (P<0.05). Conclusion: LCZ and DLT can treat allergic reactions efficiently, and relief the children with allergic rhinitis complicated with asthma effectively, but LCZ with more clinical curative effectiveness and more secure than DCZ. |
| Key words: levocetirizine desloratadine allergic rhinitis allergic asthma randomized controlled trials |
