孟鲁司特在慢性阻塞性肺疾病稳定期患者中的应用

Application of montelukast in stable patients with chronic obstructive pulmonary disease

目的观察孟鲁司特(顺尔宁)对稳定期慢性阻塞性肺疾病(简称慢阻肺)患者呼吸困难和肺功能的作用。方法 70例稳定期慢阻肺病人,随机分为治疗组(35例)和对照组(35例)两组,给予相同的基础治疗,治疗组同时加用孟鲁司特10mg,每晚1次,疗程3个月。观察两组治疗前与治疗后1、3、6个月肺功能变化、呼吸困难和急性发作情况。结果治疗组患者治疗1个月后,分钟最大通气量占预计值百分比(MVV/预计值)、用力肺活量(FVC)、一秒量占预计值的百分比(FEV_1/预计值)、一秒率(FEV_1/FVC)明显高于治疗前(均P<0.01);而在开始治疗3、6个月后与治疗1个月后的肺功能各项指标对比无显著差异(均P>0.05);对照组患者治疗前与治疗后各项肺功能指标亦有明显改善(均P<0.05);治疗后治疗组与对照组比较,差异有统计学意义(P<0.05);而且在观察期间治疗组的呼吸困难改善好于对照组,急性发作次数低于对照组(P<0.05)。结论慢阻肺稳定期患者常规治疗基础上口服孟鲁司特能更好地改善肺功能,更好地缓解呼吸困难症状,同时还能减少患者急性发作的次数。

Objective To investigate the effect of montelukast on dyspnea symptoms and pulmonary function of patients with chronic obstructive pulmonary disease（ COPD） at stable stage. Methods 70 stable COPD patients were randomly divided into the treatment group（ 35 cases） and the control group（ 35 cases）. Both groups received the same therapy,and the treatment group was additionally given 10 mg montelukast q. n for 3 months. The changes of pulmonary function,dyspnea symptoms and acute exacerbation episode were observed before and 1,3,6 months after therapy in the two groups. Results 1 month after treatment,FVC,FEV1/ prediction value,FEV1/ FVC and MVV / prediction were significantly higher than those before therapy in the treatment group（ P〈0. 01）,but there was no significant difference 3 and 6 months after treatment in the treatment group（ P〉0. 05）. It showed significant difference in the control group before and after treatment（ P〈0. 05）. The improvement of breathing difficulties was better in the treatment group than in the control group,and the number of exacerbation episodes was lower in the treatment group than in the control group（ P〈0. 05）. Conclusion Oral montelukast combined with conventional treatment can better improve pulmonary function,ease dyspnea,and reduce the exacerbation episodes in treatment of stable COPD patients.