孟鲁司特钠联合糖皮质激素治疗支气管哮喘急性发作的疗效及对血清炎性介质和体液免疫功能的影响

Clinical effect of montelukast sodium combined with glucocorticoids in the treatment of patients with acute asthma attack and its influence on serum inflammatory mediators and humoral immune function

目的 探讨孟鲁司特钠联合糖皮质激素治疗支气管哮喘急性发作临床疗效及对患者血清炎性介质和体液免疫功能影响.方法 选取温岭市第一人民医院于2018年3月至2019 年3月收治的支气管哮喘急性发作患者82例,按照随机数字表法分为对照组41例与观察组41例.对照组患者采用糖皮质激素治疗,观察组在对照组基础上结合孟鲁司特钠治疗.两组疗程均为2周.比较两组治疗疗效及治疗前后肺功能、主要症状积分、炎性介质和体液免疫功能变化.结果 观察组总有效率(92.68%)高于对照组(70.73%) (χ^2 =6.609,P<0.05).观察组治疗后第1秒用力呼气容积占预计值百分比(FEV1%)和第1秒用力呼气容积(FEV1 )/用力肺活量(FVC)均高于对照组(t=6.420、12.206,均P<0.05).观察组治疗后喘息、咳嗽和咯痰积分均低于对照组(t=14.318、7.368、15.653,均P<0.05).观察组治疗后血清白细胞介素6(IL-6)、白细胞介素17(IL-17)和白细胞介素33(IL-33)水平均低于对照组(t=10.123、10.144、9.893,均P<0.05).观察组治疗后血清免疫球蛋白( Ig) A、IgG和IgM 水平均高于对照组( t =7.695、7.698、7.835,均 P <0.05).结论 孟鲁司特钠联合糖皮质激素对支气管哮喘急性发作患者临床疗效良好,可减轻患者炎性反应,提高患者免疫功能,值得临床借鉴.

Objective To investigate the clinical efficacy of montelukast sodium combined with glucocorti-coids in the treatment of patients with acute asthma attack and its effects on serum inflammatory mediators and humoral immune function.Methods From March 2018 to March 2019,82 patients with acute asthma attack admitted to the First People's Hospital of Wenling were randomly divided into control group (41 cases) and observation group (41 cases) according to random number table method.The control group was treated with glucocorticoid ,while the observation group was treated with montelukast sodium on the basis of the control group.Both two groups were treated for 2 weeks.The therapeutic effect, pulmonary function,main symptom score,inflammatory mediators and humoral immune function before and after treatment were compared between the two groups .Results The total effective rate of the observation group (92.68%) was higher than that of the control group (70.73%) ( χ^2 =6.609,P<0.05). After treatment,FEV1%and FEV1/FVC in the observation group were higher than those in the control group ( t=6.420,12.206,all P<0.05).After treatment,the scores of asthma,cough and expectoration in the observation group were lower than those in the control group (t=14.318,7.368,15.653,all P<0.05).After treatment,the levels of IL-6,IL-17 and IL-33 in the observation group were lower than those in the control group (t=10.123,10.144, 9.893,all P<0.05).The levels of serum IgA,IgG and IgM in the observation group were higher than those in the control group (t=7.695,7.698,7.835,all P<0.05).Conclusion Montelukast sodium combined with glucocorti-coid has good clinical effect on patients with acute asthma attack.It can alleviate inflammation and improve immune function of patients,which is worthy of clinical reference.