孟鲁司特治疗慢性阻塞性肺疾病急性加重期的临床研究  

Clinical research on treatment for acute exacerbation of chronic obstructive pulmonary disease with montelukast

作　　者：温玉婷[1] 左万里[1] 黄炎明[1] 钟雪莺[1] 黄积雄[1] 

机构地区：[1]江门市中心医院呼吸内科,529000

出　　处：《国际医药卫生导报》2013年第8期1109-1113,共5页International Medicine and Health Guidance News

摘　　要：目的 观察孟鲁司特对慢性阻塞性肺疾病急性加重期（AECOPD）患者的治疗作用。方法根据诱导痰嗜酸性粒细胞百分比（EOS％）将AECOPD患者分组，A、B组患者EOS％≥3％，C、D组患者EOS％〈3％，每组20例。四组均使用抗生素等基础治疗，A组及c组加用孟鲁司特口服，10mg，QN，疗程均为14天。四组患者分别在人院第1天及第14天进行CAT评分，记录肺功能中FEV1、FEV1％pre的变化，动脉血气分析中的Pa02、PaC02、PaO2/FiO2，检测诱导痰中EOS％及半胱氨酰白三烯（CysLTs）的水平。结果与B、C组比较，A组治疗后CAT评分、PaO2、PaCO2、PaOJFi02各项指标均显著好转（P〈0．05）；FEVl、FEVl％pre也有好转，但差异无统计学意义（P〉0．05）。A组治疗后诱导痰EOS％及CysLTs水平较B组显著下降（P〈0．01）。诱导痰EOS％、CysLTs水平与CAT评分呈正相关，与FEV1、FEV1％pre、PaO2、PaO2/FiO2呈负相关（P〈0．05）。诱导痰EOS％与CysLTs水平呈正相关（P〈0．05）。结论孟鲁司特可改善气道内嗜酸性粒细胞计数升高的AECOPD患者的临床症状和生活质量，改善患者血气，减轻气道炎症；半胱氨酰白三烯可能在其中发挥重要作用。Objective To investigate the effects of montelukast in treatment for acute exacerbation of chronic obstructive pulmonary disease （COPD）. Methods 80 patients diagnosed as acute exacerbation of COPD （AECOPD） in our hospital were randomly and equally divided into 4 groups. Group A and group B subjects were the patients induced sputum＇ s eosinophilic cell count percentage ≥ 3%, and the group C and group D subjects were the patients induced sputum＇ s eosinophilic cell count percentage〈3%. All subjects were treated with antibiotic therapy. Montelukast sodimn tablets were only given to group A and group C. After 14 days, the CAT scores, blood gas analysis, pulmonary function and induced sputum were observed. Results There were more statistical significant difference in these indicators in group A when compared with those of group B and group C after treatment （P〈0.05）, such as the CAT scorns, PaO2, PaCO2 and PaO2/ FiO〉 And FEV1 and FEVl%pre in group A were better than those in group B and group C, but there were no significant difference （P〉0.05）. The induced sputum＇ s eosinophilic cell count percentage and CysLTs levels were decreased significantly （P〈0.01）. The induced sputum＇ s eosinophilic cell count percentage and CysLTs levels were significantly positively correlated with the CAT scores; and they were significantly negatively correlated with FEV 1, FEV 1% pre, PaO2 and PaOz/FiO2 （P〈0.05）. The eosinophilic cell count percentage was significantly positively correlated with CysLTs levels （P〈0.05）. Conclusion Montelukast can improve the patients＇ clinical symptoms, the quality of life, blood gas and inhibit the airway inflammation in AECOPD with eosinophilic airway inflammation. Cysttrieinyl leukoenes plays an important role in it.

关 键 词：慢性阻塞性肺疾病急性加重期 孟鲁司特 诱导痰 嗜酸性粒细胞 半胱氨酰白 三烯 

分 类 号：R563.9[医药卫生—呼吸系统]