糖皮质激素序贯孟鲁司特治疗慢性阻塞性肺疾病急性加重期的疗效观察  

Clinical Effect of Glucocorticoids Combined with Montelukast in Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：严峻海[1] 周曦[1] 李镛[1] 张柏膺[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院呼吸科,上海200020

出　　处：《中国医药导刊》2014年第4期689-690,共2页Chinese Journal of Medicinal Guide

基　　金：上海市黄浦区科委科研计划项目(卢卫科1004)

摘　　要：目的:探讨孟鲁司特的抗炎作用在慢性阻塞性肺疾病(COPD)急性加重期的临床应用。方法:将80例住院的COPD急性加重期患者随机分为实验组与对照组。实验组在常规治疗的基础上,予口服泼尼松30mg/天,五天后序贯予口服孟鲁司特10mg/天。对照组在常规治疗的基础上,予口服泼尼松30mg/天,一共十天,两组患者治疗前后分别检测肺功能、血清肿瘤坏死因子-α(TNF-α)与白介素-8(IL-8)。结果:两组患者治疗后TNF-α与IL-8的水平有显著降低(P<0.01),肺功能有显著提高(P<0.01),两组之间治疗后肺功能、TNF-α变化无差异(P>0.05),但对照组IL-8降低较实验组更加明显(P<0.05)。结论:在COPD急性加重期,糖皮质激素与孟鲁司特均有很好的抗炎作用,改善肺功能,但孟鲁司特不能完全替代糖皮质激素。Objective：To investigate the anti-inflammatory effect of montelukast in patients with acute exacerbation of chronic obstructive pulmonary disease. Methods：The 80 cases of hospitalized patients with acute exacerbation of COPD were randomly divided into experimental group and control group. The experimental group were treated with conventional treatment and prednisone 30mg/days for 5 days, then add montelukast 10mg/day. The control group were treated with conventional treatment and prednisone 30mg/day for 10 days. Plasma levels of tumor necrosis factor-α（TNF-α） interleukin-8（IL-8）, pulmonary function were measured before and after the treatment. Results：After the treatment, Plasma levels of TNF-α, IL-8 were significantly decreased and pulmonary function was significantly increased in both groups （P〈0.01）. No significant difference of pulmonary function and TNF-αbetween experimental group and control group was found after the treatment. However, the control group IL-8 was significantly lower than that in the experimental group more （P〈0.05）.Conclusion：In acute exacerbation of COPD, glucocorticoids and montelukast have a good anti-inflammatory effects, improve pulmonary function. But montelukast can not completely replace glucocorticoids.

关 键 词：慢性阻塞性肺疾病 糖皮质激素 孟鲁司特 肿瘤坏死因子-Α 白介素-8 

分 类 号：R563.9[医药卫生—呼吸系统]