孟鲁司特联合沙美特罗替卡松对咳嗽变异性哮喘患者白介素-4和γ-干扰素水平的影响  

Influence of montelukast combined with salmeterol fluticasone on interleukin-4( IL-4) and interferon-γ( IFN-γ) levels of patients with cough variant asthma

作　　者：马建波 张宇虹[2] 

机构地区：[1]浙江省衢州市柯城区人民医院呼吸科,浙江324000 [2]浙江省绍兴市人民医院干部病房,浙江312000

出　　处：《实用药物与临床》2014年第4期442-444,共3页Practical Pharmacy and Clinical Remedies

基　　金：2012浙江省医药卫生科技项目(2012ZHB023)

摘　　要：目的探讨孟鲁司特联合沙美特罗替卡松对咳嗽变异性哮喘患者白介素-4(IL-4)和γ-干扰素(IFN-γ)水平的影响。方法选择我院收治的咳嗽变异性哮喘患者74例,随机分为实验组和对照组。两组患者均予以沙美特罗替卡松吸入,1吸/次,2次/d。实验组在此基础上口服孟鲁司特咀嚼片10 mg,1次/d,连用12周。观察两组患者治疗前后血清IL-4和IFN-γ水平的变化,并观察临床疗效及安全性。结果治疗12周后,两组患者血清IL-4水平较治疗前明显下降,IFN-γ水平较治疗前明显上升(P<0.01或P<0.05),且实验组下降或上升值明显大于对照组(P<0.05);同时实验组的临床总有效率明显高于对照组(χ2=4.16,P<0.05)。对照组和实验组治疗过程中分别出现不良反应3例和6例,症状较轻,未发生严重药物不良反应。两组治疗过程中不良反应发生率比较差异无统计学意义(χ2=0.51,P>0.05)。结论孟鲁司特联合沙美特罗替卡松治疗咳嗽变异性哮喘效果明确,能降低血清IL-4水平,提高血清IFN-γ水平,纠正Thl/Th2细胞因子平衡失调,且安全性较高。Objective To discuss the influence of montelukast combined with salmeterol fluticasone on inter-leukin-4（IL-4） and interferon-γ（ IFN-γ） levels of patients with cough variant asthma. Methods 74 patients with cough variant asthma in our hospital were selected and divided into experimental group and control group at random. The patients of the two groups were given the inhibition of salmeterol fluticasone one suck per time,twice daily. The patients of the experimental group were given 10 mg montelukast dulcets additionally once daily for 12 weeks. The changes of serum IL-4 and IFN-γ levels of the two groups were observed before and after treatment,and the clinical curative effect and security were observed as well. Results After 12 weeks′treatment,the serum IL-4 level of patients of the two group declined obviously than before treatment,while the IFN-γ level rose obviously than before treatment （P〈0. 01 or P〈0. 05）,and declining or rising rate of experimental group was obviously higher than those of control group （P〈0. 05）. Meanwhile,the total clinical efficiency of experimental group was much higher than that of control group （χ2 =4. 16,P ＆lt;0. 05）. 3 and 6 cases of adverse reactions in control group and experimental group with light symptom without serious drug adverse reaction （ DAR） during the medical treatment respectively. After comparing the occurrence rates of adverse reactions in the two groups,no obvious statistical difference appeared during the medical treatment （χ2 =0. 51,P＆gt;0. 05）. Conclusion Montelukast combined with salmeterol fluticasone has reliable curative effect on cough variant asthma with high security,which has close effect on reducing serum IL-4 level,improving serum IFN-γ level,and correcting Th1/Th2 cytokine dysequilibrium.

关 键 词：哮喘 咳嗽变异性 孟鲁司特 白介素-4 Γ-干扰素 INTERLEUKIN-4 (IL-4) INTERFERON-Γ (IFN-γ) 

分 类 号：R725.6[医药卫生—儿科]