CAJ | 학술논문

目的观察孟鲁司特对慢性阻塞性肺疾病急性加重期(AECOPD)患者的治疗作用.方法根据诱导痰嗜酸性粒细胞百分比(EOS％)将AECOPD患者分组,A、B组患者EOS％≥3％,C、D组患者EOS％＜3％,每组20例.四组均使用抗生素等基础治疗,A组及C组加用孟鲁司特口服,10 mg,QN,疗程均为14天.四组患者分别在入院第1天及第14天进行CAT评分,记录肺功能中FEV1、FEV1％pre的变化,动脉血气分析中的PaO2、PaCO2、PaO2/FiO2,检测诱导痰中EOS％及半胱氨酰白三烯(CysLTs)的水平.结果与B、C组比较,A组治疗后CAT评分、PaO2、PaCO2、PaO2/FiO2各项指标均显著好转(P＜0.05);FEV1、FEV1％pre也有好转,但差异无统计学意义(P＞0.05).A组治疗后诱导痰EOS％及CysLTs水半较B组显著下降(P＜0.01).诱导痰EOS％、CysLTs水平与CAT评分呈正相关,与FEV1、FEV 1％pre、PaO2、PaO2/FiO2呈负相关(P＜0.05).诱导痰EOS％与CysLTs水平呈正相关(P＜0.05).结论孟鲁司特可改善气道内嗜酸性粒细胞计数升高的AECOPD患者的临床症状和生活质量,改善患者血气,减轻气道炎症;半胱氨酰白三烯可能在其中发挥重要作用.
목적 관찰맹로사특대만성조새성폐질병급성가중기(AECOPD)환자적치료작용.방법 근거유도담기산성립세포백분비(EOS％)장AECOPD환자분조,A、B조환자EOS％≥3％,C、D조환자EOS％＜3％,매조20례.사조균사용항생소등기출치료,A조급C조가용맹로사특구복,10 mg,QN,료정균위14천.사조환자분별재입원제1천급제14천진행CAT평분,기록폐공능중FEV1、FEV1％pre적변화,동맥혈기분석중적PaO2、PaCO2、PaO2/FiO2,검측유도담중EOS％급반광안선백삼희(CysLTs)적수평.결과 여B、C조비교,A조치료후CAT평분、PaO2、PaCO2、PaO2/FiO2각항지표균현저호전(P＜0.05);FEV1、FEV1％pre야유호전,단차이무통계학의의(P＞0.05).A조치료후유도담EOS％급CysLTs수반교B조현저하강(P＜0.01).유도담EOS％、CysLTs수평여CAT평분정정상관,여FEV1、FEV 1％pre、PaO2、PaO2/FiO2정부상관(P＜0.05).유도담EOS％여CysLTs수평정정상관(P＜0.05).결론 맹로사특가개선기도내기산성립세포계수승고적AECOPD환자적림상증상화생활질량,개선환자혈기,감경기도염증;반광안선백삼희가능재기중발휘중요작용.
Objective To investigate the effects of montelukast in treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods 80 patients diagnosed as acute exacerbation of COPD (AECOPD) in our hospital were randomly and equally divided into 4 groups.Group A and group B subjects were the patients induced sputum' s eosinophilic cell count percentage ≥ 3％,and the group C and group D subjects were the patients induced sputum' s eosinophilic cell count percentage＜3％.All subjects were treated with antibiotic therapy.Montelukast sodium tablets were only given to group A and group C.After 14 days,the CAT scores,blood gas analysis,pulmonary function and induced sputum were observed.Results There were more statistical significant difference in these indicators in group A when compared with those of group B and group C after treatment (P＜0.05),such as the CAT scores,PaO2,PaCO2 and PaO2/FiO2.And FEV1 and FEV1％pre in group A were better than those in group B and group C,but there were no significant difference (P＞0.05).The induced sputum' s eosinophilic cell count percentage and CysLTs levels were decreased significantly (P＜0.01).The induced sputum' s eosinophilic cell count percentage and CysLTs levels were significantly positively correlated with the CAT scores; and they were significantly negatively correlated with FEV1,FEV 1％ pre,PaO2 and PaO2/FiO2 (P＜0.05).The eosinophilic cell count percentage was significantly positively correlated with CysLTs levels (P＜0.05).Conclusion Montelukast can improve the patients' clinical symptoms,the quality of life.blood gas and inhibit the airway inflammation in AECOPD with eosinophilic airway inflammation.Cysttrieinyl leukoenes plays an important role in it.