孟鲁司特钠联合维生素D3改善老年哮喘气道重塑的疗效观察  

Effect of montelukast sodium combined with vitamin D3 on improving airway remodeling in elderly patients with asthma

作　　者：张知远 金海珍 ZHANG Zhiyuan;JIN Haizhen(Department of Respiratory Medicine,Wenzhou Central Hospital,Wenzhou,Zhejiang 32500,China)

机构地区：[1]浙江省温州市中心医院呼吸内科

出　　处：《重庆医学》2019年第23期4005-4008,共4页Chongqing medicine

基　　金：温州市科技计划项目（Y20080047）

摘　　要：目的 探究孟鲁司特钠联合维生素D3改善老年哮喘气道重塑的疗效。方法 选取2017年3月至2018年12月该院收治的98例老年哮喘患者,按照随机数字表法分为观察组和对照组(各49例),对照组给予孟鲁司特钠治疗,观察组在对照组基础上联合维生素D3治疗,比较治疗后两组患者的临床疗效、症状持续时间、肺功能[1s用力呼气量占预计值比例(FEV1)、FEV1与用力肺活量比值(FEV1/FVC)]、气道重塑情况、血清碱性磷酸酶、25羟基维生素D3[25-(OH)D3]和免疫球蛋白A(IgA)水平。结果 治疗后,观察组临床总有效率明显高于对照组(95.92%vs.81.63%,P<0.05);观察组患者支气管总直径(TA)、管腔面积(LA)、管壁面积(WA)值和症状持续时间明显低于对照组(P<0.05),管腔内部直径(ID)、外径(OD)和管壁厚度(WT)明显高于对照组(P<0.05)。治疗后,两组FEV1、FEV1/FVC、25-(OH)D3、IgA、碱性磷酸酶水平均升高,且观察组均明显高于对照组(P<0.05)。结论 采用孟鲁司特钠联合维生素D3治疗老年哮喘能有效缩短不良症状持续时间,降低炎性反应,抑制气道重塑,改善肺功能。Objective To investigate the effect of montelukast sodium combined with vitamin D 3 on airway remodeling in elderly patients with asthma.Methods A total of 98 elderly patients with asthma admitted to this hospital from March 2017 to December 2018 were divided into two groups according to the random number table method,49 cases in each group.The control group received montelukast sodium only,while the observation group was given montelukast sodium combined with vitamin D 3.Then the clinical efficacy,duration of symptoms,pulmonary function indexes[the percentage of forced expirator volume in one second to expected value(FEV 1),FEV 1/forced vital capacity ratio(FEV 1/FVC)],airway remodeling status,levels of serum alkaline phosphatase,25-(OH)D 3 and IgA were compared between the two groups.Results After treatment,the total clinical effective rate of the observation group was significantly higher than that of the control group(95.92%vs.81.63%,P<0.05).After treatment,the total area(TA),lumen area(LA),wall thickness(WA)of bronchus and duration of symptom in the observation group were significantly lower than those in the control group(P<0.05),while the internal diameter(ID),outside diameter(OD)and wall thickness(WT)of bronchus were significantly higher than those in the control group(P<0.05).After treatment,the values of FEV 1 and FEV 1/FVC,levels of 25-(OH)D 3,alkaline phosphatase and IgA were increased in both groups,and these indexes were significantly higher in the observation group than those in the control group(P<0.05).Conclusion The application of the montelukast sodium combined with vitamin-D 3 can effectively shorten the duration of adverse symptoms,reduce inflammation reactions,inhibit airway remodeling,and ameliorate the pulmonary function.

关 键 词：孟鲁司特钠 胆骨化醇 老年人 哮喘 气道重塑 

分 类 号：R562.25[医药卫生—呼吸系统]