孟鲁司特钠对COPD急性加重期患者肺功能和诱导痰IL-8、TNF-α的影响

Effect of Montelukast on IL-8 and TNF-α Level in Induced Sputum and the Pulmonary Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:研究孟鲁司特钠对慢性阻塞性肺疾病(COPD)急性加重期患者肺功能和诱导痰IL-8、TNF-α的影响。方法:观察40例65～70岁COPD急性加重期患者,随机分为治疗组和对照组,另选20例健康查体老年人为健康组。对照组20例仅采用常规治疗,包括抗生素治疗、氧疗、祛痰、支气管舒张剂等,治疗组20例,在常规治疗的基础上加用孟鲁司特10mg/d,治疗时间2周,于治疗前和治疗后测定IL-8、TNF-α水平及肺功能,并与健康组比较。结果:治疗前COPD患者IL-8和TNF-α水平高于健康组,COPD患者1秒钟用力呼气容积(FEV1)和1秒钟用力呼气容积占用力肺活量的百分比(FEV1/FVC%)低于健康组;治疗后,治疗组诱导痰IL-8和TNF-α水平低于对照组,FEV1水平高于对照组。结论:孟鲁司特钠减轻COPD急性加重期患者气道炎症,改善肺功能。

Objective：To study the effect of montelukast on interleukin-8（IL-8） and tumor necrosis factor-alpha （TNF-α） level in induced sputum and the pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）.Methods：Forty patients,aged from 65 to 70 years,with COPD and 20 health subjects were included in the study.Patients were randomly assigned to treatment group （n=20） and control group （n=20）.Patients of two groups were given the conventional treatment,including antibiotic therapy,oxygen therapy,expectorant and bronchodilator,but patients in treatment group were also given montelukast sodium 10 mg orally before bed for 2 weeks.The levels of IL-8,TNF-α and the pulmonary function were observed before and after treatment.Results：The levels of IL-8 and TNF-α were higher in COPD patients than those in healthy subjects before treatment.The values of forced expiratory volume in 1 second （FEV1） and FEV1/fast vital capacity （FVC） % were lower in COPD patients than those of healthy subjects.After treatment,the levels of IL-8 and TNF-α were lower in treatment group than those in control group.The value of FEV1 was higher in treatment group than that in control group.Conclusion：Montelukast can relieve the inflammation of airway,and improve the pulmonary function in patients with COPD.