孟鲁司特钠联合布地奈德雾化吸入治疗对老年慢性阻塞性肺疾病急性加重期病人免疫功能及肺功能的影响

Effects of montelukast sodium combined with budesonide inhalation on pulmonary function and immune function in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨孟鲁司特钠联合布地奈德雾化吸入治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)的疗效,及其对病人的肺功能及免疫功能指标的影响。方法 85例AECOPD病人依据随机数字表法分为对照组(n=45)和观察组(n=40),在常规对症支持治疗的基础上,对照组病人给予布地奈德雾化吸入治疗,观察组病人给予孟鲁司特钠联合布地奈德雾化吸入治疗,2组均连续治疗2个疗程。比较2组的临床疗效、治疗前后的肺功能、免疫功能及不良反应的发生情况。结果观察组疗效显著优于对照组,差异有统计学意义(P<0.05);治疗后,观察组的最大呼气峰流速(PEF)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气中断流速(MMEF)、CD3^+、CD4^+和CD4^+/CD8^+水平均显著高于对照组,CD8^+水平显著低于对照组,差异有统计学意义(P<0.05);2组均未见严重不良反应的发生,且2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论孟鲁司特钠联合布地奈德雾化吸入治疗AECOPD,可显著改善病人的临床症状、肺功能及免疫功能,临床疗效显著。

Objective To investigate the effect of montelukast sodium combined with budesonide inhalation in the treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD）.Methods A total of 85 cases of AECOPD were divided into control group（ n =45） and observation group（ n = 40） according to the random number table.On the basis of routine symptomatic supportive treatment,the patients in the control group were treated with budesonide inhalation,and patients in the observation group were treated with montelukast sodium combined with budesonide inhalation.Two groups were treated for a total of 2 courses.The clinical efficacy,the pulmonary function and immune function before and after treatment,and the incidence of adverse reactions of the two groups were compared.Results The clinical effect in observation group was significantly better than that of control group（ P〈 0.05）; After treatment,the levels of peak expiratory flow（ PEF）,forced expiratory volume in 1 second（ FEV1）,forced vital capacity（ FVC）,maximum mide xpiratory flow（ MMEF）,CD3~＋,CD4~＋and CD4~＋/CD8~＋in the observation group were significantly higher than those in control group,and the level of CD8~＋was significantly lower than that of control group（ P〈0.05）; There were no serious adverse reactions in the two groups,and there was no significant difference in the incidence rate of adverse reactions between the two groups（ P〉 0.05）.Conclusions Montelukast sodium combined with budesonide inhalation can significantly improve the clinical symptoms,lung function and immune function in the treatment of AECOPD.