孟鲁司特治疗60例稳定期老年慢性阻塞性肺疾病疗效观察

Observation on effect of montelukast in treating 60 cases of stable period of elderly chronic obstructive pulmonary disease

目的观察孟鲁司特对老年慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法将120例老年COPD稳定期咳嗽患者分为对照组和观察组,各60例;对照组在常规治疗基础上加用舒利迭,观察组在对照组基础上加用孟鲁司特(10mg/晚,连续3个月),比较两组患者的咳嗽症状、肺功能及诱导痰白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)变化。结果两组患者经治疗后咳嗽积分均较治疗前下降,第1秒末用力呼气容积(FEV1)、FEV1%、FEV1/用力肺活量(FVC)较治疗前增高,IL-8及TNF-α均下降;观察组治疗后咳嗽缓解率明显优于对照组(P=0.043);观察组肺功能明显改善,FEV1、FEV1%、FEV1/FVC均明显高于对照组(P=0.012,P=0.015,P=0.044),诱导痰IL-8、TNF-α水平低于对照组(P<0.01),差异均有统计学意义(P<0.05)。结论孟鲁司特作为老年COPD稳定期患者的补充治疗有效。

Objective To observe the effect of montelukast in treating the stable period of elderly chronic obstructive pulmo- nary disease（COPD）. Methods 120 patients with stabile period of COPD were randomly divided into the control group （60 cases） and the observation group （60 cases） ;the control group was added with Seretide based on the conventional treatment,while on the basis of the control group treatment the observation group was added with montelukast （10mg / night for 3 continuous months） based on the control group. Then the changes of cough,lung function,IL-8 and TNF-α were compared between the two groups. Re- sults The cough scores after treatment in the two groups were decreased compared with before treatment,while FEV1, FEV1 and FEV1/FVC were increased than before treatment;induced sputum IL-8 and TNF-α were decreased; the cough effective rate after treatment in the observation group was significantly better than that in the control group （P= 0. 0432） ;the tung function in the observation group was significantly improved, FEV1, FEV1 % and FEV1/FVC were significantly higher than those in the control group （P= 0. 012, P= 0. 015, P= 0. 044）, the induced sputum IL-8 and TNF-αlevels were lower than those in the control group, the differences were statistically significant （P=〈0. 001）. Conclusion Montelukast as the supplementary therapy in the stable period of elderly COPD is effective.