特布他林联合孟鲁司特钠治疗支气管哮喘患者效果及对炎性因子和呼吸力学的影响  

The effect of terbutaline combined with montelukast sodium in the treatment of bronchial asthma and its effect on inflammatory factors and respiratory mechanics

作　　者：陈垣[1] 陈华妹[1] 肖一佳 赵素娥[1] 王菊芬[1] Chen Huamei;Xiao Yijia;Zhao Sue;Wang Jufen(Department of Respiratory Medicine,Changsha Central Hospital,Changsha 410004,China)

机构地区：[1]湖南省长沙市中心医院呼吸内科

出　　处：《疑难病杂志》2020年第1期26-29,35,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察特布他林联合白三烯受体拮抗剂孟鲁司特钠治疗支气管哮喘患者效果及对呼吸力学的影响。方法选取2018年1月-2019年3月长沙市中心医院呼吸内科治疗的支气管哮喘患者98例作为研究对象,随机数字表法分为单药组、联合组各49例,单药组患者以孟鲁司特钠治疗,联合组患者以特布他林联合孟鲁司特钠治疗。治疗3个月后,比较2组治疗前后血清超敏C反应蛋白(hs-CRP)、白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α),血清谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA),血清免疫球蛋白水平,检测呼吸力学指标水平,评价治疗效果、不良反应发生情况。结果治疗后联合组患者血清hs-CRP、IL-17、TNF-α水平均低于单药组(t/P=5.685/0.001、8.447/0.001、6.124/0.001),血清GSH-Px、SOD水平高于单药组、MDA水平低于单药组(t/P=4.575/0.001、4.904/0.001、5.049/0.001),IgA、IgM、IgG、IgE水平均低于单药组(t/P=3.546/0.001、2.688/0.008、6.687/0.001、6.393/0.001),呼吸做功(WOB)、气道峰压(PIP)、气道阻力(Raw)水平低于单药组、动态顺应性(Cdyn)水平高于单药组(t/P=5.936/0.001、11.940/0.001、3.936/0.001、9.779/0.001)。联合组患者治疗总有效率高于单药组(95.92%vs.81.63%,χ~2/P=5.018/0.025),不良反应发生率略高于单药组,但差异无统计学意义(P>0.05)。结论特布他林联合孟鲁司特钠治疗支气管哮喘患者,能够抑制炎性反应,提升患者抗氧化能力及免疫功能,改善患者呼吸功能,治疗效果显著。Objective To observe the effect of terbutaline combined with leukotriene receptor antagonist montelukast sodium in the treatment of bronchial asthma and its effect on respiratory mechanics.Methods From January 2018 to March2019,98 patients with bronchial asthma who were treated in respiratory department of Changsha Central Hospital were selected as the study objects,and randomly divided into single drug group and combined group with 49 cases each.Patients in the single drug group were treated with montelukast sodium,while patients in the combined group were treated with terbutaline and montelukast sodium.After 3 months of treatment,the serum levels of hs CRP,IL-17,TNF-a,GSH-Px,SOD,MDA and immunoglobulin were compared before and after treatment.The level of respiratory mechanics index was detected,and the therapeutic effect and adverse reactions were evaluated.Results Serum hs CRP,IL-17,and TNF-a levels were lower in the combination group than in the single-agent group(t/P=5.685/0.001,8.447/0.001,6.124/0.001),and serum GSH-Px and SOD levels were higher than in the single-agent group after treatment The MDA level was lower than that of the single drug group(t/P=4.575/0.001,4.904/0.001,5.049/0.001).The levels of IgA,IgM,IgG,and IgE were lower than those of the single drug group(t/P=3.546/0.001,2.688/0.008,6.687/0.001,6.393/0.001),respiratory work(WOB),peak airway pressure(PIP),The airway resistance(Raw) level was lower than the single drug group,and the dynamic compliance(Cdyn) level was higher than the single drug group(t/P=5.936/0.001,11.940/0.001,3.936/0.001,9.779/0.001).The total effective rate of the combined group was higher than that of the single-agent group(95.92% vs.81.63%,χ~2/P-5.018/0.025),and the incidence of adverse reactions was slightly higher than that of the single-agent group,but the difference was not statistically significant(P> 0.05).Conclusion Terbutaline combined with montelukast sodium in the treatment of bronchial asthma can inhibit the inflammatory response,improve the antioxidant capacit

关 键 词：特布他林 孟鲁司特钠 支气管哮喘 呼吸力学 炎性因子 免疫功能 

分 类 号：R562.25[医药卫生—呼吸系统]