孟鲁司特治疗老年稳定期慢性阻塞性肺疾病患者的疗效分析  

Analysis of therapeutic effect of montelukast in elderly stable patients with moderate on severe chronic obstructive pulmonary disease

作　　者：赵恬[1] 顾亮[1] 杜坚宗[1] 钦光跃[1] 

机构地区：[1]浙江医院呼吸内科

出　　处：《中国临床药理学与治疗学》2013年第1期66-70,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：浙江省医药卫生科技计划项目(2007B018)

摘　　要：目的:评价孟鲁司特治疗老年稳定期中重度慢性阻塞性肺疾病(COPD)患者的疗效及安全性。方法:60例男性稳定期中重度COPD患者随机分为治疗组和对照组,在规则吸入布地奈德联合福莫特罗(信必可都保)的基础上,治疗组加服孟鲁司特,疗程6个月。比较两组患者治疗前后基础呼吸困难指数(BDI)、圣乔治呼吸问卷(SGRQ)评分、肺功能、诱导痰细胞分类及白三烯B4(LTB4)水平。结果:47例患者完成试验,期间未发生孟鲁司特相关严重药物不良反应。两组患者经治疗后BDI均升高,SGRQ评分及诱导痰中性粒细胞百分比均下降(P<0.05),但肺功能均无明显改善(P>0.05)。与对照组相比,治疗组患者诱导痰中嗜酸性粒细胞百分比下降,且BDI、SGRQ评分、诱导痰LTB4水平的改善作用更明显,两组改善率差异有统计学意义(P<0.05)。结论:孟鲁司特作为老年稳定期中重度COPD患者的补充治疗安全有效。AIM： To evaluate the efficacy and safety of montelukast in elderly patients affected by stable moderate to severe chronic obstructive pulmonary disease（COPD）. METHODS： In this randomized, prospective, single-blind, and con- trolled study, 60 COPD patients treated with formoterol plus budesonide were randomized to receive treatment of oral montelukast for 6 months （montelukast group） or not （control group）. The baseline dyspnea index（BDI）, the St George＇s Respiratory Questionnaire （SGRQ） scores, pulmonary function tests（PFTs）, induce sputum and the levels of LTB4 were compared before and after the treatment in two groups. RESULTS.47 patients had completed the study, no severe montelukast relevant side effects were reported during the observation period. After the treatment,the BDI was increased in the two groups,but the SGRQ score and the percentage of neutrophil of induced sputum were decreased （P（0.05）, the pulmonary functions were not markedly improved （P） 0.05 ）. Compared with the control group, the percentage of neutrophils of induced sputum in montelukast group was de- creased; the BDI, the SGRQ score, the levels of LTB4 had significant improvement, there were statistically significant difference （ P 〈 0.05 ）. CONCLUSION. The treatment of montelukast added to inhaled budesonide and formoterol in elderly stable patients with moderate to severe COPD is effective and safe.

关 键 词：盂鲁司特 白三烯受体拮抗剂 慢性阻塞性肺疾病 疗效 

分 类 号：R563[医药卫生—呼吸系统]