扎鲁司特对支气管哮喘患者的疗效评价

The effects of leukotriene receptor antagonist zafirlukast in patients with asthma and its mechanisms

目的 观察白三烯受体拮抗剂———扎鲁司特对轻、中度哮喘缓解期患者的疗效及其对气道炎症和气道高反应性的影响。方法 将 36例轻、中度哮喘缓解期患者随机分为 2组 :扎鲁司特组 2 2例 ,口服扎鲁司特 2 0mg,2次 /d ,加吸吸入型 β2 肾上腺素能受体激动剂 (喘乐宁气雾剂 ,每喷 10 0μg) ,按需使用 ;对照组 14例 ,按需使用喘乐宁气雾剂。疗程均为 4周。治疗前后观察日间哮喘症状评分、夜间憋醒次数、吸入喘乐宁的使用量 ,测定肺功能和气道反应性 ,同时测血清嗜酸细胞阳离子蛋白 (ECP)、肿瘤坏死因子 (TNF)α及白细胞介素 (IL) 8。结果 (1)扎鲁司特组患者治疗后日间哮喘症状评分下降 [治疗前为 (1 7± 0 7)分 ,治疗后为 (1 1± 0 8)分 ;P <0 0 1],夜间憋醒次数减少 [治疗前为(1 1± 0 9)次 /晚 ,治疗后为 (0 6± 0 7)次 /晚 ;P <0 0 1],吸入喘乐宁的使用量减少 [治疗前为 (3 6±1 2 )喷 /d ,治疗后为 (2 4± 1 1)喷 /d ;P <0 0 1];(2 )肺功能 :1秒钟用力呼气容积升高 [治疗前为(2 15± 0 42 )L ,治疗后为 (2 41± 0 6 3)L ;P <0 0 1],最大呼气流速峰值升高 [治疗前为 (4 5 8± 1 2 2 )L/s ,治疗后为 (5 19± 1 2 6 )L/s ;P <0 0 5 ];(3)气道反应性 :起始呼吸阻力下降 [治疗前为

Objective To observe the effect of zafirlukast in treating mild to moderate interval phase asthma and its influence on airway inflammation and airway hyperresponsiveness Methods 36 interval phase patients with mild to moderate asthma were assigned to 2 groups The zafirlukast group was treated with oral zafirlukast(20 mg,bid) plus inhaled β agonist as needed for 4 weeks The control group was treated with inhaled β agonist alone as needed for 4 weeks Changes in daytime asthma symptom scores, nighttime awakening, use of inhaled β agonist, respiratory function test, airway responsiveness, concentrations of serum eosinophil cationic protein, tumor necrosis factor α and interleukin 8 were observed oresfimated Results (1) Zafirlukast significantly decreased daytime symptoms scores [(1 7±0 7)score vs (1 1±0 8)score;P<0 01], nighttime awakening(1 1±0 9 vs 0 6±0 7;P<0 01),inhaled β agonist use [(3 6±1 2)puffs/d vs( 2 4±1 1) puffs/d; P<0 01];(2)It significantly increased forced expiratory volume in 1 second [(2 15±0 42)L vs (2 41± 0 63)L;P<0 01],and peak expiratory flow rate[(4 58±1 22)L/s vs (5 19±1 26) L/s;P<0 05];(3)It significantly decreased airway responsiveness ,Rrs(6 39±2 25) cm H 2O·L -1 ·s -1 vs( 5 36±1 94) cm H 2O· L -1 ·s -1 ,P<0 01; Dmin(1 96±1 88)u vs (22 04±20 65)u,P<0 01;Sd(3 26±2 14) cm H 2O·L -1 ·s -1 ·U -1 vs (0 29±0 25) cm H 2O·L -1 ·s -1 ·U -1 , P<0 01;respectively;(4)It significantly decreased the concentrations of serum eosinophil cationic protein[(7 98±6 38) μg/L vs (4 22±2 45) μg/L;P<0 01]. Conclusions Zafirlukast has therapeutic effect in mild to moderate interval phase asthma, including decreasing asthma symptoms, improving respiratiory function, diminishing airway hyperresponsiveness and anti airway inflammation