孟鲁司特钠联合复方异丙托溴铵治疗老年支气管哮喘急性发作的临床疗效

Clinical effect of montelukast sodium combined with compound ipratropium bromide in the treatment of acute attack of bronchial asthma in the elderly

目的观察孟鲁司特钠联合复方异丙托溴铵治疗老年支气管哮喘急性发作的临床疗效。方法选取2020年2月—2021年2月娄底市中心医院收治的老年支气管哮喘急性发作患者104例,随机分为A组和B组,各52例。A组予以雾化吸入复方异丙托溴铵溶液治疗,B组在A组的基础上联合孟鲁司特钠片治疗。2组疗程均为7 d。比较2组临床疗效,肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰值流速(PEF)]、炎性因子[白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、干扰素-γ]、免疫功能指标(CD_(3)^(+)T淋巴细胞百分比、CD_(4)^(+)T淋巴细胞百分比、CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值),并观察2组不良反应。结果 B组总有效率为92.30%,高于A组的76.92%(χ^(2)=4.727,P<0.05)。治疗后,B组FVC、FEV1、PEF、干扰素-γ高于A组,IL-6、TNF-α低于A组(P<0.01)。治疗后,B组CD_(3)^(+)T淋巴细胞百分比、CD_(4)^(+)T淋巴细胞百分比、CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值高于A组(P<0.01)。B组不良反应总发生率为13.46%,与A组的11.53%比较,差异无统计学意义(χ^(2)=0.087,P> 0.05)。结论孟鲁司特钠联合复方异丙托溴铵治疗老年支气管哮喘急性发作的临床疗效确切,有利于改善肺功能,减轻炎性反应,提高免疫功能,且安全性较高。

Objective To study the clinical effect of montelukast sodium combined with compound ipratropium bromide in the treatment of acute attack of bronchial asthma in the elderly.Methods A total of 104 cases of elderly patients with acute attack of bronchial asthma were selected from February 2020 to February 2021 in Loudi Central Hospital,which were randomly divided into group A and group B,with 52 cases in each group.Group A was treated with aerosol inhalation of compound ipratropium bromide solution,while group B was treated with montelukast sodium tablets on the basis of group A.The treatment course of both groups was 7 days.Clinical efficacy,pulmonary function indexes[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),peak expiratory flow rate(PEF)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor α(TNF-α) and interferon-γ],immune function indexes(percentage of CD_(3)^(+)T lymphocyte,percentage of CD_(4)^(+)T lymphocyte,CD_(4)^(+)/CD_(8)^(+)T lymphocyte ratio) before and after treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results The total effective rate of group B was higher than that of group A(92.30% vs.76.92%,χ^(2)= 4.727,P< 0.05).After treatment,FVC,FEV1,PEF and IFN-γ in group B were higher than those in group A,while IL-6 and TNF-α were lower than those in group A(P< 0.05).After treatment,the percentage of CD_(3)^(+)T lymphocyte,percentage of CD_(4)^(+)T lymphocyte and CD_(4)^(+)/CD_(8)^(+)T lymphocyte ratio in group B were higher than those in group A(P< 0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(13.46% vs.11.53%,χ^(2)= 0.087,P> 0.05).Conclusion Montelukast sodium combined with compound ipratropium bromide have an exact clinical effect for acute attack of bronchial asthma in the elderly,it is beneficial to improve lung function,relieve inflammatory reaction and improve immune function,and with high safety.