背景:登革热继续在全球范围内构成重大的健康挑战,比哈尔邦最近爆发的疫情,印度,促使人们寻找有效的治疗干预措施。这项研究评估了孟鲁司特的有效性,传统上用于哮喘,减轻登革热症状的严重程度及其向登革热休克综合征(DSS)的进展。
目的:评价孟鲁司特对成人登革热预警标志患病率和DSS发生率的影响。
方法:在英迪拉·甘地医学科学研究所(IGIMS)进行了一项前瞻性观察性研究,巴特那,印度,从2022年8月到2023年10月,招募500名诊断为登革热的患者。参与者分为两组。约250例接受孟鲁司特治疗,250例接受标准护理。测量的结果包括警告标志的发生率,DSS,住院时间,30天死亡率
结果:与对照组相比,孟鲁司特组的登革热警告信号患病率降低了24%,孟鲁司特组250例患者中有90例(36%),对照组250例患者中有150例(60%)(p<0.001)。孟鲁司特组DSS发生率明显降低,250例患者中有4例(1.6%),对照组250例患者中有21例(8.4%)(比值比:0.178,p<0.001)。此外,蒙鲁克特使用者的住院时间较短(平均4.52天与6.54天,T统计量:-7.59,p=1.58×10-13)和降低的30天死亡率,孟鲁司特组250例患者中有5例(2%),对照组250例患者中有12例(5%)(p<0.03)。
结论:孟鲁司特可显著降低登革热预警信号和DSS的发生率,缩短住院时间,并降低登革热患者的死亡率,支持其与现有登革热治疗方案的潜在整合。这项研究强调需要进一步的临床试验来证实这些发现,并充分了解孟鲁司特在登革热管理中的治疗机制。
BACKGROUND: Dengue fever continues to pose significant health challenges globally, with recent outbreaks in Bihar, India, prompting a search for effective therapeutic interventions. This study assesses the effectiveness of Montelukast, traditionally used for asthma, in mitigating the severity of dengue fever symptoms and its progression to dengue shock syndrome (DSS).
OBJECTIVE: To evaluate the impact of Montelukast on the prevalence of dengue warning signs and the incidence of DSS in adult patients.
METHODS: A prospective observational study was conducted at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, India, from August 2022 to October 2023, enrolling 500 patients diagnosed with dengue fever. Participants were divided into two groups. About 250 were treated with Montelukast and 250 received standard care. Outcomes measured included the incidence of warning signs, DSS, length of hospital stay, and 30-day mortality.
RESULTS: The Montelukast group exhibited a 24% lower prevalence of dengue warning signs compared to the control group, with 90 out of 250 patients (36%) in the Montelukast group versus 150 out of 250 patients (60%) in the control group (p < 0.001). The incidence of DSS was significantly reduced in the Montelukast group, with 4 out of 250 patients (1.6%) compared to 21 out of 250 patients (8.4%) in the control group (odds ratio: 0.178, p < 0.001). Furthermore, Montelukast users experienced shorter hospital stays (average 4.52 days vs. 6.54 days, T-statistic: -7.59, p = 1.58×10-13) and a reduced 30-day mortality rate, with 5 out of 250 patients (2%) in the Montelukast group versus 12 out of 250 patients (5%) in the control group (p < 0.03).
CONCLUSIONS: Montelukast significantly lowers the incidence of dengue warning signs and DSS, shortens hospital stays, and decreases mortality rates among dengue patients, supporting its potential integration into existing dengue treatment protocols. This study highlights the need for further clinical trials to confirm these findings and fully understand the therapeutic mechanisms of Montelukast in dengue management.