孟鲁司特治疗支气管哮喘的疗效及对 外周血细胞因子含量的影响

Curative effect of Montelukast therapy for bronchial asthma and its effect on content of cytokines in peripheral blood

摘要:

目的 研究孟鲁司特治疗支气管哮喘的疗效及对外周血细胞因子含量的影响。方法 选取2014 年 7 月-2016 年8 月天津市海河医院就诊的114 例支气管哮喘发作患者，随机分为接受舒利迭吸入剂治疗的对 照组以及接受舒利迭吸入剂联合孟鲁司特治疗的观察组，观察治疗过程中哮喘发作、急性加重、药物不良反 应的例数以及短效β2 受体激动剂的使用次数；治疗前后采集血清并测定细胞因子含量，采用肺功能仪测定 气道功能指标。结果 观察组患者治疗后3 个月内的症状发生率、急性加重率均低于对照组，短效β2 受体激 动剂使用次数均少于对照组，药物不良反应的发生率与对照组比较差异无统计学意义；治疗后3 个月时，观察 组患者血清中IL-2、IFN-γ、CGRP 的含量均高于对照组，IL-4、IL-10、MMP-9、TGF-β 的含量均低 于对照组，FEV1/FVC 比值以及FEF25、FEF50、FEF75 水平高于对照组。结论 孟鲁司特治疗支气管哮喘能 够减少哮喘发作和短效β2 受体激动剂使用次数，同时抑制气道炎症反应和气道重塑，改善气道功能。

Abstract:

Objective To study the curative effect of Montelukast therapy in the treatment of bronchial asthma and its effect on the content of cytokines in peripheral blood. Methods A total of 114 cases of acute bronchial asthma patients in our hospital between July 2014 and August 2016 were enrolled and randomly divided into two groups, The patients in the control group received Seretide inhalation treatment and those in the observation group received Seretide inhalation combined with Montelukast. Then the number of cases with asthma attack, acute exacerbation or adverse drug reactions, and the frequency of use of short β2 agonists were observed. Before and after treatment, cytokine content in serum and airway function indexes were determined. Results Within 3 months of treatment, the incidences of asthma attack and acute exacerbation and the frequency of use of short β2 agonists in the observation group were lower than those in the control group (P < 0.05), however, the incidence of adverse drug reactions had no significant difference from that in the control group (P > 0.05). Three months after treatment, the serum content of IL-2, IFN-γ and CGRP in the observation group was significantly higher than that in the control group; the serum content of IL-4, IL-10, MMP-9 and TGF-β was significantly lower than that in the control group; the FEV1/FVC ratio and the levels of FEF25, FEF50 and FEF75 were significantly higher than those in the control group. Conclusions In the treatment of acute exacerbation of bronchial asthma, Montelukast therapy can reduce the incidence of asthma attack and the frequency of use of short β2 agonists, inhibit airway inflammation and airway remodeling, and improve airway function.