CAJ | 학술논문

目的了解嗜酸粒细胞性支气管炎(EB)的发病率,评价孟鲁司特与吸入激素(布地奈德)治疗EB的疗效与安全性.方法对慢性咳嗽患者,遵循我国咳嗽指南慢性咳嗽诊断流程进行诊断.确诊EB患者随机分成3组,甲组为孟鲁司特治疗组,乙组为布地奈德治疗组,丙组为孟鲁司特联合布地奈德治疗组,疗程4周.比较其疗效与安全性.结果慢性咳嗽患者467例,其中56例确诊EB患者(占12％),治疗前三组患者性别、年龄、咳嗽病史、咳嗽症状评分、诱导痰嗜酸粒细胞(Eos)比例及嗜酸粒细胞阳离子蛋白(ECP)、白三烯C4( LTC4)相比较,差异均无统计学意义(P＞0.05),三组治疗后改善咳嗽症状有效率、治疗前后外周血Eos计数差异无统计学意义(P＞0.05),三组治疗后诱导痰Eos分类、ECP、LTC4较治疗前明显降低(P＜0.01),治疗后丙组诱导痰Eos分类、ECP、LTC4较甲组、乙组降低(P＜0.05),三组间不良反应发生率差异无统计学意义(P＞0.05).结论 EB发病率较高,是慢性咳嗽的常见原因.孟鲁司特单独或联合布地奈德能改善EB咳嗽症状及降低气道嗜酸粒细胞性炎症.
목적 료해기산립세포성지기관염(EB)적발병솔,평개맹로사특여흡입격소(포지내덕)치료EB적료효여안전성.방법 대만성해수환자,준순아국해수지남만성해수진단류정진행진단.학진EB환자수궤분성3조,갑조위맹로사특치료조,을조위포지내덕치료조,병조위맹로사특연합포지내덕치료조,료정4주.비교기료효여안전성.결과 만성해수환자467례,기중56례학진EB환자(점12％),치료전삼조환자성별、년령、해수병사、해수증상평분、유도담기산립세포(Eos)비례급기산립세포양리자단백(ECP)、백삼희C4( LTC4)상비교,차이균무통계학의의(P＞0.05),삼조치료후개선해수증상유효솔、치료전후외주혈Eos계수차이무통계학의의(P＞0.05),삼조치료후유도담Eos분류、ECP、LTC4교치료전명현강저(P＜0.01),치료후병조유도담Eos분류、ECP、LTC4교갑조、을조강저(P＜0.05),삼조간불량반응발생솔차이무통계학의의(P＞0.05).결론 EB발병솔교고,시만성해수적상견원인.맹로사특단독혹연합포지내덕능개선EB해수증상급강저기도기산립세포성염증.
Objective To investigate the prevalence of eosinophilic bronchitis (EB),evaluate the treatment efficiency and safety on EB by montelukast and inhaled corticosteroids (budesonide).Methods EB from the chronic cough patients was diagnosed according to diagnostic criteria published by Chinese cough guidelines.The cases of EB were divided into three groups randomly.A group was treated with montelukast,B group with budesonide,C group with montelukast and budesonide,lasting for four weeks.The efficiency and safety of three groups were compared.Results 56 cases (12％) of EB were defined in 467 chronic cough patients.Among the three groups,there was no statistical significance on sex,age,cough history,cough symptom scores, induced sputum eosinophils ratio,eosinophilcationicprotein (ECP),leukotriene C4 (LTC4) before treatment ( P ＞ 0.05),no statistical significance on cough symptom improvement efficiency and the peripheral blood eosinophils count after treatment ( P ＞0.05).The induced sputum eosinophils ratio,ECP,LTC4 were all obviously reduced after treatment ( P ＜0.01),while those in C group were reduced than those in the other two groups ( P ＜0.05).There was no statistical significance on the incidence of side effects among the three groups ( P ＞0.05).Conclusions The prevalence of EB is high,and EB is an important cause for chronic cough.Montelukast single or union budesonide can relieve the cough of EB and eliminate eosinophilic airway inflammation.