孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者的影响  

Effect of montelukast combined with tiotropium bromide in bronchial asthma patients in remission stage

作　　者：魏胜全[1] 薛华 王惠霞[1] 贾汝臻 WEI Shengquan;XUE Hua;WANG Huixia;JIA Ruzhen(Department of Respiratory Diseases,Baoji City People′s Hospital,Baoji,Shaanxi,721000;Department of Respiratory Diseases,Xianyang City People′s Hospital,Xianyang,Shaanxi,712000)

机构地区：[1]陕西省宝鸡市人民医院呼吸科,陕西宝鸡721000 [2]陕西省咸阳市人民院呼吸科,陕西咸阳712000

出　　处：《实用临床医药杂志》2020年第14期48-52,共5页Journal of Clinical Medicine in Practice

基　　金：陕西省卫生厅科研项目(2014JM04023)。

摘　　要：目的探讨孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者诱导痰中炎症介质、T细胞亚群水平和黏附因子水平的影响。方法选取支气管哮喘缓解期患儿96例,采用随机数字表将96例患儿分为观察组和对照组,每组48例。对照组给予噻托溴铵治疗,观察组给予孟鲁司特联合噻托溴铵治疗,2组均连续治疗3个月。比较2组治疗前后肺功能指标,诱导痰中炎性因子、T细胞亚群和黏附因子水平变化及治疗中不良反应。结果治疗后,观察组第1秒用力呼气容积(FEV 1)、用力肺活量(FVC)和最大用力呼吸峰流量占预计值百分比(PEF%)均显著高于对照组(P<0.05);观察组诱导痰中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子(TNF-α)水平显著低于对照组(P<0.05);诱导痰中Th1、CD8+CD28-、CD4+CD25+水平显著高于对照组,Th2、Th17水平显著低于对照组(P<0.05);观察组诱导痰中细胞间黏附分子-1(ICAM-1)、血管黏附分子-1(VCAM-1)、CD44水平显著低于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论孟鲁司特联合噻托溴铵治疗支气管哮喘缓解期患者,能有效减轻气道局部炎症、黏附性,调节免疫功能。Objective To explore the effects of montelukast combined with tiotropium bromide on the levels of inflammatory mediators,T cell subsets and adhesion factors in induced sputum of patients with bronchial asthma during remission.Methods A total of 96 children patients with bronchial asthma during remission period were selected.According to random number table method,96 children patients were divided into observation group and control group,with 48 cases in each group.Control group was treated with tiotropium bromide,and observation group was given montelukast combined with tiotropium bromide,and the two groups were continuously treated for 3 months.The levels of lung function indexes and inflammatory factors,T cell subsets and adhesion factors in induced sputum before and after treatment,and adverse reactions during treatment were compared between the two groups.Results After treatment,the forced expiratory volume in 1 second(FEV 1),forced vital capacity(FVC)and percentage of maximum forced respiratory peak flow in predicted value(PEF%)in the observation group were significantly higher than those in the control group(P<0.05);the levels of interleukin-6(IL-6)、interleukin-8(IL-8)and tumor necrosis factor(TNF-α)in the observation group were significantly lower than those in the control group(P<0.05);the Th1,CD8+CD28-and CD4+CD25+in induced sputum were significantly higher than those in the control group,while the Th2 and Th17 were significantly lower than those in the control group(P<0.05);the levels of intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1)and CD44 in induced sputum in the observation group were significantly lower than those in control group(P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Montelukast combined with tiotropium bromide in the treatment of patients with bronchial asthma during remission can effectively recieve local airway inflammation and adhesion,and regulate im

关 键 词：孟鲁司特 噻托溴铵 支气管哮喘缓解期 诱导痰 T细胞亚群 

分 类 号：R562.2[医药卫生—呼吸系统]