观察白三烯受体拮抗剂(LTRAs)对哮喘-慢阻肺重叠(ACO)患者的临床症状、气道炎症及肺功能的影响

Observation of influence of clinical symptoms,airway inflammation and pulmonary function of leukotriene receptor antagonists(LTRAs)in patients with asthmachronic obstructive pulmonary overlap(ACO)

目的观察白三烯受体拮抗剂(LTRAs)对哮喘-慢阻肺重叠(ACO)患者临床症状、气道炎症及肺功能的影响。方法选取2017年1月至2018年12月本院收治的ACO患者100例,按照治疗方法的不同分为对照组(n=50,采用布地奈德/福莫特罗粉吸入剂治疗)和研究组(n=50,采用孟鲁斯特联合布地奈德/福莫特罗粉吸入剂治疗),比较两组患者治疗前后CAT评分、呼出气一氧化氮(FeNO)、ACT评分、诱导痰嗜酸粒细胞(E%)、诱导痰中性粒细胞(N%)、肺功能FEVl占预计值的百分比(FEVl%pred)、FEVl/FVC指数。结果治疗后,两组患者CAT评分、FeNO、ACT评分、E%、N%均较治疗前降低,FEVl%pred、FEVl/FVC指数均较治疗前提高,研究组CAT评分、FeNO、ACT评分、E%、N%均明显低于对照组,差异均有统计学意义(P<0.05);两组FEVl%pred、FEVl/FVC比较差异无统计学意义。结论白三烯受体拮抗剂能明显改善哮喘-慢阻肺重叠患者的呼吸道症状和气道炎症,但对患者的肺功能影响不明显。

Objective To observe the effect of leukotriene receptor antagonists(LTRAs)on the clinical symptoms,airway inflammation and pulmonary function in patients with asthma-COPD(ACO).Methods From January 2017 to December 2018,100 patients with ACO in our hospital were divided into control group(n=50,treated with budesonide/formoterol powder)and study group(n=50,treated with montelukast and budesonide/formoterol powder)according to different treatment methods.The CAT score and exhaled nitric oxide(FeNO),ACT score,induced sputum eosinophils(E%),neutrophils(N%),FEVl%Pred and FEVl/FVC index of the two groups were compared before and after treatment.Results After treatment,the CAT score,FeNO,ACT score,E%and N%of the two groups were lower than before treatment,FEV1%Pred,FEVl/FVC index were higher than before treatment,the CAT score,FeNO,act score,E%and N%of the study group were significantly lower than that of the control group,the difference was statistically significant(P<0.05).The FEV%Pred and FEV1/FVC of the two groups were not statistically significant.Conclusion Leukotriene receptor antagonists can significantly improve the respiratory symptoms and airway inflammation in patients with asthmatic COPD,but have no significant effect on the pulmonary function.