PDF(Pubmed)
Abstract：
Background: Adenoidal hypertrophy (AH) is one of the most common causes of upper airway obstruction in children. Drug and surgical treatment are the typical treatment of AH. The study on the inflammatory mechanism of AH in children provides a new idea for preoperative intervention and non-surgical treatment with anti-inflammatory drugs such as montelukast sodium (a cysteine leukotriene receptor antagonist). The aim of this study is to evaluate the effect of montelukast sodium on adenoidal lymphoid tissue pathology in children with AH under light microscope. Objective: To study whether there is any change in pathology of the adenoidal lymphoid tissue under the light microscope compared with the control group in children with moderate to severe simple AH treated with montelukast sodium for 1 month before operation. Materials and methods: Twenty patients (8 males, 12 females, 3-8 years old) with moderate to severe AH who were prepared for surgical treatment were selected. All the patients were examined by Nasopharyngeal CT and hemocyte analysis before operation. 20 subjects were randomly divided into two groups: One group was given montelukast chewable tablets 5 mg/d, qn, for 4 weeks; The control group was given placebo 5 mg/d, qn, for 4 weeks. After 4 weeks, the adenoids were removed and examined histopathology. Results: Compared with the control group, the number of lymphocytes in the blood cell analysis of the study group was significantly reduced, with a statistically significant difference (p < 0.05). And the number of germinal centers in adenoid tissue of the study group was relatively reduced, no small cyst was found in the epithelium, and the degree of inflammatory cell infiltration was reduced, with a statistically significant difference (p < 0.05). Conclusion: Montelukast can reduce the number of reactive cells, the number of lymphocytes in blood cells and blood vessels in adenoid lymphoid tissue, which can provide a new idea for preoperative intervention and non-surgical treatment of adenoid hypertrophy in children. However, this is only a pilot study and a longer treatment period is needed to assess the long-term effects of montelukast sodium on adenoid lymphoid tissue. Clinical Trial Registration: www.Chictr.org.cn, identifier ChiCTR2300075040.
摘要：
背景：腺样体肥大（AH）是儿童上呼吸道阻塞的最常见原因之一。药物和手术治疗是AH的典型治疗方法。对儿童AH炎症机制的研究为孟鲁司特钠(一种半胱氨酸白三烯受体拮抗剂)等抗炎药物的术前干预和非手术治疗提供了新思路。本研究旨在在光镜下评价孟鲁司特钠对AH患儿腺样淋巴组织病理的影响。目的:研究孟鲁司特钠治疗1个月的中重度单纯AH患儿术前与对照组相比,光镜下是否有腺样淋巴组织病理学改变。材料和方法：20例患者（8例男性，12名女性,3-8岁），选择准备手术治疗的中度至重度AH。所有患者术前均行鼻咽CT检查及血细胞分析。20例受试者随机分为两组:一组给予孟鲁司特咀嚼片5mg/d,qn,4周;对照组给予安慰剂5mg/d,qn,4周。4周后,摘除腺样体并进行组织病理学检查.结果:与对照组相比,研究组的血细胞分析中的淋巴细胞数量显着减少，差异有统计学意义(p<0.05)。研究组腺样体组织生发中心数量相对减少,在上皮中没有发现小囊肿,炎症细胞浸润程度减轻,差异有统计学意义(p<0.05)。结论:孟鲁司特可减少反应性细胞的数量,腺样淋巴组织中血细胞和血管中的淋巴细胞数量，为儿童腺样体肥大的术前干预和非手术治疗提供了新的思路。然而,这只是一项初步研究,需要更长的治疗时间来评估孟鲁司特钠对腺样淋巴组织的长期影响.临床试验注册：www。Chictr.org.cn,标识符ChiCTR2300075040。
