半胱氨酰白三烯受体拮抗剂在Guidelines中的地位(修改后)(1).ppt

* * TABLE II. Outcome frequencies in the 12 months after dispensing the controller medication in a subset of subjects who were continuously enrolled for the 12 months after controller medication dispensing: the number of subjects who experienced 1 or more ED visits, hospitalizations, oral courses of oral corticosteroids In subjects who metcriteria for continuous enrollment, 21% of patients in TennCare Medicaid who filled an ICS experienced an exacerbation compared with 17% of patients who filled an ICS-LABA or 14% who filled an LTRA (P 0 .001). * * Figure 3. Algorithm of preventive pharmacologic treatment for asthma in children 2 years of age Regular controller therapy. The main goal of regular controller therapy should be to reduce bronchial inflammation. 常规控制剂治疗的主要目标是减少气道炎症 LTRA? An alternative first-line treatment for persistent asthma. 持续性哮喘可选的一线治疗? Evidence supports use of oral montelukast as an initial controller therapy for mild asthma in children (153), as it provides bronchoprotection (154), and reduces airway inflammation as measured by nitric oxide levels in some preschool children with allergic asthma (155, 156). 有证据显示口服孟鲁司特是儿童轻度哮喘的首选控制剂，它可提供气道保护的作用，在学龄前过敏性哮喘的儿童中通过检测一氧化氮证实其可以减少气道炎症? Younger age (10 years) and high levels of urinary leukotrienes predict a favorable response to LTRA(149). 较小的年龄（10岁）和高水平的尿白三烯支持使用LTRA治疗? A therapy for patients who cannot or will not use ICS. 患者不能或不愿意使用ICS? Useful also as add-on therapy to ICS as their mechanisms of action are different and complementary(157). 因为作用机制不同，联合ICS治疗可互补? Suggested as treatment for viral-induced wheeze and to reduce the frequency of exacerbations in young children aged 2–5 years (158, 159). 治疗2-5岁患儿的病毒诱发喘息可以减少急性发作频率? Benefit has been shown in children as young as 6 months of age (156, 160). 对于6个月患儿也显示有益处 * * * * * * * * Figure 4 The stepwise approach to asthma treatment in childhood aims at disease control. Reliever medication should be used at any level of severity/control, if symptoms app