孟鲁司特治疗血清白三烯增高、呼出气一氧化氮阳性咳嗽变异性哮喘患者的效果

Clinical efficacy of montelukast in patients with elevated serum LTC4 and FeNO-positive cough variant asthma

目的探讨孟鲁司特对不同血清白三烯LTC4及呼出气一氧化氮(FeNO)水平成人咳嗽变异性哮喘患者的临床疗效及预后研究。方法选取本院呼吸科门诊初诊为咳嗽变异性哮喘(cough variantasthma,CVA)的患者120例为研究组,分为A组(血清LTC4增高、FeNO阴性组)、B组(血清LTC4增高、FeNO阳性组)、C组(血清LTC4不高、FeNO阳性组)、D组(血清LTC4不高、FeNO阴性组),每组各30例。另选择30例健康人作为对照组。A、B、C、D四组均应用孟鲁司特10 mg每晚1次口服治疗,治疗1、3个月后分别进行咳嗽严重症状评分、LTC4、PEF、FeNO水平疗效评价,治疗结束后随访3个月。结果 A组受试者治疗1、3个月后咳嗽症状缓解,血清LTC4水平、PEF变异率均减低,差异有统计学意义(P <0.05);B组受试者治疗1、3个月后咳嗽症状缓解,血清LTC4水平、FeNO水平、PEF变异率均减低,差异有统计学意义(P <0.05);两组疗效差异无统计学意义(P> 0.05)。C组受试者治疗1个月后咳嗽症状略缓解,FeNO水平、PEF变异率略减低,差异无统计学意义(P> 0.05);D组受试者治疗1个月后咳嗽症状略缓解,PEF变异率略减低,差异无统计学意义(P> 0.05)。结论孟鲁司特对血清LTC4增高的成人CVA患者临床疗效好,对血清LTC4不高的成人CVA患者临床疗效差。在3个月有效治疗期间,治疗时间越长,疗效越好。

Objective elevated serum LTC4 and FeNO-positive cough variant asthma as well as its prognosis.Methods patients with cough variant asthma(CVA)were selected from the outpatient department of the respiratory department of our hospital and divided into groups A(increased serum LTC4,FeNO negative group),B(increased serum LTC4,FeNO positive group),C(low serum LTC4,FeNO positive group),and D(low serum LTC4,FeNO negative group),30 cases in each group. Another 30 healthy people were selected as the control group. All groups A,B,C and D received oral treatment of 10 mg montelukast once a night. After 1 month and 3 months of treatment,the efficacy of severe cough symptom score,LTC4,PEF and FeNO levels were evaluated respectively,and the patients were followed up for 3 months after the treatment. Follow-up visits were conducted for 3 months after the end of treatment.Results In group A,the cough symptoms were relieved after 1 month and 3 months of treatment,and the serum LTC4 level and PEF mutation rate were significantly reduced(P < 0.05). The cough symptoms in group B were relieved after 1 month and 3 months of treatment,and the serum LTC4 level,FeNO level,and PEF mutation rate were all reduced,the difference was statistically significant(P < 0.05);there was no statistical difference in the efficacy between the two groups(P > 0.05). The cough symptoms of the subjects in group C were slightly relieved after 1 month of treatment,FeNO levels and the PEF variation rate was slightly reduced,without statistically significant difference(P > 0.05). After 1 month of treatment,the cough symptoms in group D were slightly relieved and the PEF variation insignificantly reduced(P > 0.05).Conclusion Montelukast has a good clinical effect in the treatment of adult CVA patients with elevated serum LTC4,but it is poor clinically for treating adult CVA patients with low serum LTC4. During the effective treatment period of 3 months,the longer the treatment duration is,the better the effect.