口服孟鲁司特钠治疗慢性阻塞性肺疾病急性加重期疗效及安全性的Meta分析  

Meta-analysis of efficacy and safety of oral montelukast in chronic obstructive pulmonary disease with acute exacerbation

作　　者：李威[1] 闫芳[1] 王晶[1] 

机构地区：[1]新疆医科大学第一附属医院呼吸一科,乌鲁木齐830054

出　　处：《中华临床医师杂志（电子版）》2015年第9期151-153,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的评价口服孟鲁司特钠治疗慢性阻塞性肺疾病急性加重期(AECOPD)疗效及安全性,为孟鲁司特钠在临床上治疗AECOPD提供更为可靠、科学的依据。方法计算机检索万方、维普、超星、Web-of science、science online、nature等相关数据库,以孟鲁司特钠、白三烯受体拮抗剂、慢性阻塞性肺病、肺气肿、慢性支气管、montelukast、leukotriene receptor antagonist、chronic obstructive pulmonary disease为检索词,检索公开发表的关于孟鲁司特钠治疗AECOPD的随机对照试验(RCT),共纳入8个研究。通过Meta分析的方法,采用Rev Man 5.0进行Meta分析。结果共纳入8个研究,口服孟鲁司特钠组第1秒用力呼气量(FEV1)、占预计值的百分比(FEV1%PRE)、第1秒用力呼气量与用力肺活量的百分比[(FEV1/FVC)%]、动脉血气氧分压(PO2),均高于对照组,WMD分别为0.39 L(95%CI为0.28~0.51,P<0.05)、8.54%(95%CI为6.61~10.48,P<0.05)、15.53%(95%CI为2.64~28.43,P>0.05)、6.92 mm Hg(95%CI为5.20~8.64,P<0.05),二氧化碳分压(PCO2)低于对照组,WMD为-1.94 mm Hg(95%CI为-3.18^-0.71,P>0.05)。口服孟鲁司特钠组不良反应发生率高于对照组,合并OR值9.30(95%CI为1.44~75.91,P>0.05),差异不具有统计学意义。结论口服孟鲁司特钠治疗AECOPD,能够明显改善患者肺功能、动脉血气,但尚不能证明口服孟鲁司特钠的不良反应发生率高于对照组。Objective To assess the effectiveness and safety of oral-taken montelukast in the treatment of acute exacerbation chronic obstructive pulmonary disease （AECOPD）, providing a more reliable and scientific evidence for the clinical treatment of AECOPD by montelukast. Methods We searched Wanfang, Weipu, Chaoxing, Web-of science, science online, nature databases by computer, using montelukast Sodium, Leukotrienes receptor antagonist, chronic obstructive pulmonary disease, emphysema, chronic bronchitis as the key words, research the public published Randomized Controlled Trial （RCT） on montelukast treating AECOPD, totally include 8 trials, Meta-analysis was performed using the RevMan 5.0 software. Results 8 trials were included, in oral-taken montelukast group, the forced expiratory volume in 1 second （FEV1）, FEV1/PRE%, FEV1/FVC%, arterial blood gas oxygen partial pressure （PO2） were both higher than the control group. WMD respectively were 0.39 L （95% CI were 0.28-0.51, P〈0.05）, 8.54%（95%CI were 6.61-10.48, P〈0.05）, 15.53%（95%CI were 2.64-28.43, P〉0.05）, 6.92 mmHg （95%CI were 5.20-8.64, P〈0.05）. The partial pressure of carbon dioxide （PCO2） was lower than the control group. WMD was-1.94 mmHg （95%CI was-3.18--0.71, P〉0.05）. Oral-taken montelukast group had a higher adverse effect occurrence rate, combined OR value was 9.30 （95%CI：1.44-75.91, P〉0.05）, the difference had no statistical significance. Conclusion Oral taken Montelukast on the treatment of acute exacerbation chronic obstructive pulmonary disease can significantly improve the patients’ lung function, arterial blood gas oxygen, but there is no evidence in oral-taken montelukast group had a higher adverse effect occurrence rate than the control group.

关 键 词：肺疾病 慢性阻塞性 META分析 投药 口服 孟鲁司特钠 

分 类 号：R563.9[医药卫生—呼吸系统]