孟鲁司特钠联合复方甲氧那明对感染后咳嗽患者气道炎症、ICAM-1、TLR4和sPD-L1水平的影响  

Effects of montelukast sodium combined with compound methoxyphenamine on airway inflammation,intercellular adhesion molecule-1,toll-like receptor 4,and soluble programmed death ligand 1 levels in patients with post-infection cough

作　　者：廖凤珍 林龙芳 王佳洁 周畅 冯林 Liao Fengzhen;Lin Longfang;Wang Jiajie;Zhou Chang;Feng Lin(Department of Health Medicine,The 903 Hospital of PLA Joint Logistics Support Force,Hangzhou 310002,Zhejiang Province,China)

机构地区：[1]解放军联勤保障部队第九〇三医院健康医学科,杭州310012

出　　处：《中国基层医药》2024年第11期1627-1632,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨孟鲁司特钠联合复方甲氧那明对感染后咳嗽(PIC)患者气道炎症、细胞间黏附分子1(ICAM-1)、Toll样受体4(TLR4)和可溶性程序性死亡配体1(sPD-L1)水平的影响。方法选取解放军联勤保障部队第九〇三医院2023年1—12月收治的PIC患者200例为研究对象,采用随机对照研究,依据随机数字表法分为观察组100例和对照组100例。对照组口服复方甲氧那明胶囊,观察组在口服复方甲氧那明胶囊基础上联合孟鲁司特钠,两组疗程7 d。比较两组治疗效果、治疗前后日间和夜间咳嗽评分、气道炎症变化、血清ICAM-1、TLR4和sPD-L1水平的变化及生活质量变化(采用莱赛斯特咳嗽生活质量问卷评估)。结果观察组总有效率为95%(95/100),高于对照组的84%(84/100)(Z=2.49,P<0.05)。治疗后,观察组日间咳嗽评分、夜间咳嗽评分分别为(1.24±0.31)分、(1.02±0.31)分,均低于对照组的(2.17±0.65)分、(1.94±0.47)分(t=12.91、16.34,均P<0.001);观察组超敏C反应蛋白[(8.84±2.21)mg/L]、白细胞介素8[(82.34±13.24)mg/L]和肿瘤坏死因子α[(78.94±13.24)ng/L]均低于对照组的(12.76±2.53)mg/L、(127.18±35.17)mg/L和(102.31±21.08)ng/L(t=11.67、11.93、9.39,均P<0.001);观察组ICAM-1[(178.32±21.23)μg/L]和TLR4[(7.45±2.32)ng/L]均低于对照组的(247.18±25.64)μg/L和(19.98±4.53)ng/L,而sPD-L1[(2.34±0.37)ng/L]高于对照组的(1.72±0.41)ng/L,差异均有统计学意义(t=20.69、24.62、-11.23,均P<0.001);观察组生活质量评分:社会[(2.61±0.25)分]、心理[(6.56±0.45)分]、生理[(7.65±0.72)分]和总分[(16.81±2.51)分]均高于对照组的(2.14±0.30)分、(5.44±0.52)分、(6.07±0.65)分和(13.74±2.68)分(t=12.04、16.29、16.29、8.36,均P<0.001)。结论孟鲁司特钠联合复方甲氧那明对PIC患者疗效显著,且可减轻气道炎症反应,降低ICAM-1和TLR4水平,提高sPD-L1水平。Objective To investigate the effects of montelukast sodium combined with compound methoxyphenamine on airway inflammation,intercellular adhesion molecule-1(ICAM-1),toll-like receptor 4(TLR4),and soluble programmed death ligand 1(sPD-L1)levels in patients with post-infection cough.Methods A total of 200 patients with post-infection cough who received treatment at The 903 Hospital of the PLA Joint Logistics Support Force from January to December 2023 were included in this randomized controlled study.The patients were divided into an observation group(n=100)and a control group(n=100)using the random number table method.The control group received oral administration of compound methoxyphenamine capsules,while the observation group received oral administration of montelukast sodium in addition to compound methoxyphenamine capsules.Both groups were treated for 7 days.The therapeutic effects as well as daytime and nighttime cough scores,airway inflammation change,serum ICAM-1,TLR4,and sPD-L1 levels,and Leicester Cough Questionnaire scores were compared between the two groups.Results The total effective rate in the observation group was 95%(95/100),which was significantly higher than that in the control group[84%(84/100),Z=2.49,P<0.05].After treatment,the daytime and nighttime cough scores in the observation group were(1.24±0.31)points and(1.02±0.31)points,respectively,which were significantly lower than those in the control group[(2.17±0.65)points,(1.94±0.47)points,t=12.91,16.34,both P<0.001].Serum levels of hypersensitive C-reactive protein,interleukin-8,tumor necrosis factor-alpha in the observation group were(8.84±2.21)mg/L],(82.34±13.24)mg/L,and(78.94±13.24)ng/L,respectively,which were significantly lower than those in the control group[(12.76±2.53)mg/L,(127.18±35.17)mg/L,(102.31±21.08)ng/L,t=11.67,11.93,9.39,all P<0.001].The ICAM-1 and TLR4 levels in the observation group were(178.32±21.23)μg/L and(7.45±2.32)ng/L,respectively,which were significantly lower than those in the control group[(247.18±25.64

关 键 词：咳嗽 呼吸道感染 胞间黏附分子1 Toll样受体4 程序性细胞死亡1配体2蛋白 C反应蛋白质 白细胞介素8 肿瘤坏死因子α 孟鲁司特钠 复方甲氧那明 

分 类 号：R56[医药卫生—呼吸系统]