沙美特罗替卡松联合孟鲁司特钠对支气管哮喘患者血清炎症因子水平、T淋巴细胞亚群、肺功能的影响

Effect of salmeterol-fluticasone combined with montelukast sodium on serum inflammatory factors levels,T lymphocyte subsets levels and lung function in patients with bronchial asthma

目的探讨沙美特罗替卡松联合孟鲁司特钠对支气管哮喘患者血清炎症因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平、T淋巴细胞亚群、肺功能的影响。方法选择2017年10月至2018年10月于新疆维吾尔自治区喀什地区结核病防治所进行支气管哮喘治疗的124例患者作为研究对象,采用随机数字表法分为对照组与研究组,每组62例。对照组患者使用沙美特罗替卡松治疗,研究组患者使用沙美特罗替卡松联合孟鲁司特钠治疗。对比两组患者血清炎症因子水平、临床症状及体征消失时间、T淋巴细胞亚群以及肺功能。结果治疗前两组患者CRP、TNF-α、IL-8、IL-6水平差异无统计学意义(P>0.05)。治疗后研究组患者CRP、TNF-α、IL-8、IL-6水平均低于对照组(P<0.05)。治疗后研究组患者胸闷、气促、咳嗽等临床症状及体征消失时间均短于对照组(P<0.05)。治疗前两组患者T淋巴细胞亚群差异无统计学意义(P>0.05),治疗后研究组CD3^+、CD4^+、CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组(P<0.05)。治疗前两组患者呼气峰流速、用力肺活量、第1秒用力呼气容积比较,差异无统计学意义(P>0.05),治疗后研究组患者上述肺功能指标水平均优于对照组(P<0.05)。结论对支气管哮喘患者应用沙美特罗替卡松联合孟鲁司特钠治疗,能够显著降低患者血清炎症因子水平,改善机体免疫功能及肺功能,显著缩短临床症状及体征消失时间,促进机体恢复,疗效确切,值得临床推广。

Objective To investigate the effects of salmeterol-fluticasone combined with montelukast sodium on serum inflammatory factors(IL-6,IL-8,TNF-α,CRP),T lymphocyte subsets levels and lung function in the patients with bronchial asthma.Methods A total of 124 patients with bronchial asthma treated in Kashi Area Institute for Tuberculosis Prevention and Treatment from October 2017 to October 2018 served as the study subjects and divided into the control group and study group by adopting the random number table method,62 cases in each group.The control group was treated with salmeterol-fluticasone,while the study group was treated with salmeterol-fluticasone combined with montelukast sodium.Serum inflammatory factors levels,clinical symptom disappearance time,T lymphocyte subsets,and lung function were compared between the two groups.Results There was no statistical difference in CRP,TNF-α,IL-8,IL-6 before treatment between the two groups(P>0.05).The levels of CRP,TNF-α,IL-8 and IL-6 after treatment in the treatment group were lower than those in the control group(P<0.05).The disappearance time of clinical symptoms and signs such as chest distress,shortness of breath and cough after treatment in the study group was less than that in the control group(P<0.05).The T lymphocyte subsets levels before treatment had no statistical difference between the two groups(P>0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+after treatment in the treatment group were higher than those in the control group,while the CD8+level was lower than that in the control group(P<0.05).The levels of lung function indexes such as PEF,FVC and FEV1 before treatment had no statistical difference between the two groups(P>0.05).The above-mentioned lung function indexes after treatment in the treatment group were superior to those in the control group(P<0.05).Conclusion Salmeterol-fluticasone combined with montelukast sodium for treating bronchial asthma can significantly reduce the levels of serum inflammatory factors,improve the body′s immune function and lung function,significantly shorten the disappearance of clinical symptoms and signs,promote the body recovery,has definite effect,and is worthy of clinical promotion.