Orta-Ağır Akut Astım Atağı ile Başvuran 6-16 Yaş arası Çocuklarda Montelukastın Etkinliğinin Belirlenmesi

Year 2017, Volume: 39 Issue: 3, 1 - 8, 12.10.2017

Beyhan Küçükbayrak Koray Harmancı Gülşen Köse Hülya Anıl

https://doi.org/10.20515/otd.323970

Abstract

Öz: Bu çalışmanın amacı 
orta veya ağır şiddette astım atağı ile 
başvuran 6-16 yaşlar arasındaki 
hastalardaki solunum parametrelerine (retraksiyon, astım atak skoru,
pozitif ekspirasyon akış hızı, dispne parametreleri, oskültasyon bulguları)
montelukastın etkisini araştırmaktır. Çalışmamıza orta ve ağır şiddette akut
astım atağı ile başvuran 30 astımlı çocuk dahil edildi. Çalışma; randomize,
çift kör, plasebo kontrollü, paralel bir incelemedir. Tüm hastalara başlangıç
tedavisi olarak  nebulize salbutamol All
patients were given nebulized salbutamol (0.15 mg/kg), ipratropium bromid (250
mcg/doz), oral metilprednizolon (1 mg/kg) ve oksijen verildi. Bu tedavilere ek
olarak Grup I’deki hastalara  5 mg
plasebo, Grup II’dekilere montelukast 5 mg oral olarak verildi. Ardından her
iki gruba da  20 dakika aralarla 2 kez
daha 0,15 mg/kg nebulize salbutamol ile 250 mcg/doz nebulize ipratropium bromür
verildi. Hastalar 0., 20., 40., 60., 90., 120., 180. ve 240. dakikalarda
respiratuar parametrelerle tedavi etkinliği açısından tekrar
değerlendirildi.  Çalışmaya dahil edilen
çocukların yaşları 6,5 ile 16 arasında değişmekte ve ortanca yaş 9, erkek kız
oranı eşitti. Grup I’de hastaların median yaşı 9,5 yaş, erkek kız oranı 0.87
idi. Grup II’de hastaların median yaşı 9 yaş, erkek kız oranı 1.14 idi. Tedavi
öncesi gruplar arasında çalışma parametreleri arasında anlamlı fark bulunmadı
(p > 0.05). Bununla birlikte grup-II’deki ortalama solunum
parametrelerindeki düzelme oranı grup-I’e göre daha yüksek bulundu. Grup
II’deki hastaların astım atak skorlarındaki düzelme tüm dakikalarda diğer gruba
göre daha yüksekken, aradaki fark istatistiksel olarak anlamlı değildi  (p > 0.05). Montelukastın 6-16 yaş arası
orta veya ağır şiddette  astım atağı ile
başvuran çocuklarda kullanımında PEFR’de ve astım atak skorlarının düzelmesinde
etkili olduğu saptanmıştır.         

Keywords

Akut astım, anti-astmatik ilaçlar, çocuklar

The Effects of Montelukast in Children Between 6-16 Years with Moderate-Severe Acute Asthma Attack

Abstract

Abstract: The aim of this study is to evaluate
the effect to respiratory parameters (retraction, asthma attack score-AAS,
positive expiratory flow rate- PEFR-, dispnea parameters, auscultation) of
montelukast in children aged between 6-16 years admitted with moderate or
severe acute asthma attacks.  In this
study, thirty children presented with moderate or severe asthma attack were
evaluated. The study is a randomized, double blind, placebo-controlled parallel
trial. The patients were randomly divided into two groups. All patients were
given nebulized salbutamol (0.15 mg/kg), ipratropium bromide (250 mcg/doz), 1
mg/kg of oral methyl prednisolone and O2 as initial treatment. In addition to
these medications, the placebo of montelukast 5 mg was given orally in the
Group I, and  montelukast 5 mg drug was
given orally to the patients in the Group II. Then, additional 0.15 mg/kg
nebulized Salbutamol and 250 mcg/dosage Ipratropium bromides were given twice
with 20 minute interval. Besides, the patients were evaluated at 0., 20., 40.,
60., 90., 120., 180., and 240. minutes for the criteria of therapeutic response
such as respiratory parameters.  The mean
age of children in the study group was 9 (between 6.5-16), male to female
ration (M/F) was 1. In the first group, mean age 9.5, M/F:0.87. Median age was
9 and (M/F) was 1.14 in Group II. No significant difference was determined
between groups in terms of respiratory parameters. Nevertheless, the average
rate of improvements in the respiratory parameters in group II was higher than
group I. The rates of improvement in the average scores at every evaluation
times were higher in the group II    in
comparison with the group I. However, the differences between the groups at
every evaluation time were not significant statistically (p>0.05). The use
of montelukast in children aged between 6-16 years with acute asthma
exacerbation seems to be effective in improvement of respiratory parameters,
especially in PEFR and AAS.

Keywords

Acute asthma, anti-asthmatic agents, children

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