孟鲁司特对支气管哮喘患者血清嗜酸性粒细胞阳离子蛋白及白细胞介素4水平的影响

Influence of Montelukast on Serum ECP and IL-4 Levels in Patients with Bronchial Asthma

目的观察孟鲁司特对支气管哮喘患者血清嗜酸性粒细胞阳离子蛋白(ECP)及白细胞介素4(IL-4)水平的影响。方法 44例患者均给予孟鲁司特钠咀嚼片10 mg,每晚1次,口服,共治疗4周;于治疗前后应用肺功能仪测定用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC和呼气峰值流速(PEF),应用哮喘控制测试表(ACT)进行哮喘控制评价;采用酶联免疫吸附法(ELISA)测定血清ECP及IL-4水平,并与30名健康体检者进行对照。结果与健康对照组比较,哮喘患者血清ECP及IL-4水平明显升高(P<0.01);孟鲁司特治疗后,哮喘患者血清ECP及IL-4水平均显著下降(P<0.01),肺功能指标FVC,FEV1,FEV1/FVC和PEF显著改善,ACT评分明显提高(P<0.05或P<0.01)。孟鲁司特治疗哮喘的完全控制率为38.64%,良好控制率为52.27%,总有效率为90.91%。结论孟鲁司特能显著改善哮喘患者的肺功能,降低血清ECP和IL-4水平,可能是孟鲁司特拮抗哮喘气道炎症的重要作用机制之一。

Objective To observe the influence of montelukast on serum eosinophil cationic protein （ECP） and the interleukin-4 （IL- 4） levels in the patients with bronchial asthma. Methods 44 cases of bronchial asthma were given oral Montelukast Sodium Chewable Tablets 10 mg, once per night, for 4 weeks. The forced vital capacity （FVC）, first second forced expiratory volume （FEVI）, FEVI/FVC and peak expiratory flow （PEF） before and after treatment were measured by the lung function instrument; the Asthma Control Test （ACT） was adopted to perform the asthma control evaluation; the enzyme- linked immunosorbent assay （ELISA） was used to determine serum ECP and IL-4 levels, and the detected results were compared with those detected in 30 healthy controls. Results Compared with the healthy controls, serum ECP and IL-4 levels in the asthma patients were significantly increased, the difference was statistically significant （P 〈 O. 01）; after montelukast treatment, serum ECP and IL-4 levels in the asthma patients were significantly decreased （P 〈0.01）, the lung function indexes FVC, FEV~, FEV1/FVC and PEF were significantly improved, the ACT scores were significantly increased （P 〈0.05 or P 〈0.01）. The complete control rate of montelukast in treating asthma was 38.64%, the better control rate was 52.27% and the total effective rate was 90. 91%. Conclusion Montelukast can significantly improve the lung function in the asthma patients, has definite effect in treating asthma, the patient＇s tolerance is good. Reducing serum ECP and IL-4 levels may be one of the important action mechanisms in which montelukast shows the antagonistic effect against airway inflammation.