鲁司特与阿斯美对老年慢性阻塞性肺炎患者炎症因子影响及疗效观察

Effects of and Smeton on inflammatory mediator levels and therapeutic outcomes in elderly patients with chronic obstructive pulmonary disease

目的 探讨孟鲁司特及阿斯美对老年急性发作期慢性阻塞性肺炎（COPD）患者炎症因子水平影响及疗效观察. 方法 选取2012年6月至2013年6月在浙江大学医学院附属第一医院老年病中心住院的急性发作期COPD患者90例.随机分成孟鲁司特组和阿斯美组.两组患者均给予抗感染、维持水电解质平衡等常规治疗.孟鲁司特组在常规治疗的基础上加用孟鲁司特10 mg,每晚1次,睡前口服;阿斯美组在常规治疗的基础上加用复方制剂阿斯美25 mg,3次/d,连用2个月.观察两组患者治疗前后血浆炎症因子的变化,并进行疗效观察. 结果 孟鲁司特组治疗前后超敏C反应蛋白分别为（15.23±4.39） mg/L、（4.01±0.69） mg/L;白介素-10分别为（7.86±3.24） μg/L、（19.44±6.35） μg/L;阿斯美组治疗前后超敏C反应蛋白分别为（14.36±3.51） mg/L、（7.09±1.70） mg/L;白介素-10分别为（6.7±2.8） μg/L、（11.6±3.2） μg/L;治疗2个月后两组患者血浆超敏C反应蛋白（hs-CRP）较前明显下降,白介素-10（IL-10）水平较前明显上升（P＜0.05或＜0.01）,且孟鲁司特组下降或上升的幅度较阿斯美组更明显（P＜0.05）;阿斯美组患者的临床总有效率（95.6％）高于孟鲁司特组（82.2％）（x2 =4.05,P＜0.05）. 结论 在急性发作期（COPD）肺患者的治疗中,孟鲁司特具有较好改善炎症因子的作用,但阿斯美临床症状改善优于孟鲁司特.

Objective To compare the effects of and Smeton on inflammatory mediator levels and therapeutic outcomes in elderly patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.Methods Ninety AECOPD patients hospitalized at our department from June 2012 to June 2013 were selected and randomly divided into the group and the Smeton group.In addition to routine therapy,such as anti-infection medication and water ＆ electrolyte balance maintenance,for both groups,patients in the group were given a single 10 mg oral dose of,taken at night before bedtime,while patients in the Smeton group were given 2 pills of a compounding formulation containing,three times a day,for two months.Changes in plasma inflammatory mediator levels before and after treatment and therapeutic outcomes were monitored.Results Highsensitivity C-reactive protein （hs-CRP） levels decreased and interleukin-10 （IL-10） levels increased two months after treatment,compared with pretreatment levels [hs-CRP,（4.01±0.69） mg/L vs.（15.23±4.39） mg/L,and IL-10,（19.44±6.35） g/L vs.（7.86±3.24） g/L,for the group; hsCRP,（7.09±1.70） mg/L vs.（7.86±3.24） g/L,andIL-10,（11.6±3.2 g/L vs.6.7±2.8 g/L）,for the Smeton group; P＜0.05 or 0.01].The magnitude of increases or decreases in inflammatory mediator levels was greater in the group than in the Smeton group （P＜0.05 for both）,and the overall effectiveness rate was higher in the Smeton group than in the group （95.6％ vs.82.2％,x2 =4.05,P ＜0.05）.Conclusions When used for treatment of patients with AECOPD,ontelukast has more beneficial effects on inflammatory mediator levels,whereas is more effective in clinical symptom improvement.