孟鲁司特钠联用酮替芬治疗慢性阻塞性肺疾病急性加重期伴气道高反应性患者的效果观察  

Clinical research of Montelukast Sodium and Ketotifen on chronic obstructive pulmonary disease with airway hyper reactivity

作　　者：吴英[1] 张媛梅[1] 钱农[2] 

机构地区：[1]四川省内江市第一人民医院呼吸内科,四川内江641000 [2]江苏省常州市第二人民医院影像科,江苏常州213003

出　　处：《中国医药导报》2013年第31期82-84,共3页China Medical Herald

基　　金：江苏省卫生厅医学科研招标立项课题(编号H200863)

摘　　要：目的观察孟鲁司特钠治疗慢性阻塞性肺疾病急性加重期(AECOPD)伴气道高反应性(AHR)患者效果和肺功能的变化。方法 AECOPD伴AHR患者100例按就诊顺序分成常规组及试验组,每组各50例,两组均使用敏感抗菌素抗感染,氨茶碱、沙丁胺醇、布地奈德溶液以平喘,氨溴索祛痰,全身使用糖皮质激素、吸氧等;试验组在常规组基础上加服孟鲁司特钠10 mg,qn,富马酸酮替芬1.38 mg,qn,疗程14 d,观察临床表现、治疗前后的肺功能、血气分析、超敏C反应蛋白(hs-CRP)和纤维蛋白原(FIB)的变化。结果试验组和常规组总有效率分别为94%、76%,差异有统计学意义(P<0.05);治疗后,试验组和常规组的一秒钟用力呼气容积(FEV1)分别为(1.87±0.29)、(1.35±0.28)L,FEV1占预计值的百分比分别为(54.05±4.93)%、(50.40±5.67)%,1秒率(FEV1/FVC)分别为(55.44±3.06)%、(54.27±2.80)%,血氧分压(PaO2)分别为(87.14±7.32)、(78.38±8.09)mm Hg,二氧化碳分压(PaCO2)分别为(43.98±3.63)、(46.04±3.28)mm Hg,hsCRP分别为(4.70±2.67)、(11.61±5.63)mg/L,FIB分别为(2.43±0.84)、(5.07±0.78)g/L,差异均有统计学意义(均P<0.05)。结论孟鲁司特钠联用酮替芬治疗AECOPD伴AHR疗效确切,显著改善肺功能,降低全身炎症反应。Objective To observe the curative effect and the change of pulmonary function about Montelukast Sodium and Ke- totifen in acute exacerbation chronic obstructive pulmonary disease with airway hyperreactivity. Methods 100 patients about AECOPD with AHR were divided equally into rule treatment group and intervention group, with 50 cases in each group. The groups used the antibioticses for anti-infection, used Aminophylline, Salbutamol and Budesonide for antiasthma, used Am- broxol for expelling phlegm, and used the glucocorticoids and oxygen inspired. The treatments of intervention group were same with the rule treatment group in addition to the use of 10 mg of Montelukast Sodium qn and 1.38 mg of Ketotifen qn. The clinical symptoms and signs, the change of pulmonary function, blood gas analysis, hs-CRP and FIB in anterior-posterior of treatment were subsequently observed. Results The remission rate of the intervention group and the rule treatment group was 94% and 76% respectively （P 〈 0.05）. FEVI, FEVI% prediction, FEVI/FVC, PaO2 were significantly increased. Wheras, Pa- CO2, hs-CRP and FIB were dramatically decreased （P 〈 0.05）. In posterior of treatment, the FEVI of the rule treatment group and intervention group were respectively （1.87±0.29）, （1.35±0.28） L, the prediction of FEVx were respectively （54.05±4.93）%, （50.40±5.67）%, the FEV1/FVC were respectively （55.44±3.06）%, （54.27±2.80）%, the PaO2 were respectively （87.14±7.32）, （78.38±8.09） mm Hg, the PaCO2 were respectively （43.98±3.63）, （46.04±3.28） mm Hg, the hs-CRP were respectively （4.70± 2.67）, （11.61±5.63） mg/L, the FIB were respectively （2.43±0.84）, （5.07±0.78） g/L, the data of two groups had statistically significant differences （P 〈 0.05）. Conclusion The treatment effectiveness of Montelukast Sodium and Ketotifen are positive in AECOPD with AHR, which can change the pulmonary function and decrease the systemic inflammation.

关 键 词：孟鲁司特钠 酮替芬 慢性阻塞性肺疾病急性加重期 气道高反应性 肺功能 超敏C反应蛋白 血浆纤维蛋白原 

分 类 号：R563.1[医药卫生—呼吸系统]