孟鲁司特钠联合沙丁胺醇治疗支气管哮喘的疗效及对气道阻力和血清VCAM-1、CXCL13的影响探讨

Effect of montelukast sodium combined with salbutamol in the treatment of bronchial asthma and its influence on airway resistance and serum VCAM-1 and CXCL13

目的研究孟鲁司特钠联合沙丁胺醇治疗支气管哮喘的疗效及对气道阻力和血清血管细胞粘附分子-1(VCAM-1)、血清C-X-C趋化因子13(CXCL13)的影响。方法50例支气管哮喘患者,按随机数字表法分为对照组和研究组,每组25例。对照组给予沙丁胺醇治疗,研究组给予沙丁胺醇联合孟鲁司特钠治疗。比较两组患者临床疗效、不良反应发生率及治疗前后气道阻力指标[呼吸道总阻抗(Z5)、总气道阻力(R5)、中心气道阻力(R20)、周边气道弹性阻力(X5)]、血清VCAM-1及CXCL13水平。结果研究组治疗总有效率92.0%明显高于对照组的68.0%,差异具有统计学意义(P<0.05)。治疗后,两组Z5、R5、R20、X5均小于治疗前,且研究组Z5(0.28±0.11)kPa/(L·s)、R5(0.30±0.08)kPa/(L·s)、R20(0.32±0.06)kPa/(L·s)、X5(0.86±0.05)kPa/(L·s)均小于对照组的(0.32±0.04)、(0.36±0.07)、(0.41±0.07)、(0.98±0.20)kPa/(L·s),差异具有统计学意义(P<0.05)。治疗后,两组血清VCAM-1及CXCL13水平均低于治疗前,且研究组血清VCAM-1(425.83±12.52)μg/L、CXCL13(46.83±17.56)pg/ml显著低于对照组的(475.21±11.37)μg/L、(58.35±13.72)pg/ml,差异具有统计学意义(P<0.05)。研究组不良反应发生率12.0%与对照组的8.0%比较,差异无统计学意义(P>0.05)。结论沙丁胺醇联合孟鲁司特钠治疗支气管哮喘较单用沙丁胺醇疗效更显著,降低气道阻力及血清VCAM-1、CXCL13水平的效果更明显。

Objective To study the effect of montelukast sodium combined with salbutamol in the treatment of bronchial asthma and its influence on airway resistance and serum vascular cell adhesion molecule-1(VCAM-1)and C-X-C motif ligand 13(CXCL13).Methods A total of 50 patients with bronchial asthma were divided into control group and research group according to random numerical table,with 25 cases in each group.The control group was treated with salbutamol,and the research group was treated with salbutamol combined with montelukast sodium.Both groups were compared in terms of clinical efficacy,incidence of adverse reactions,and airway resistance indexes[total airway impedance(Z5),total airway viscous resistance(R5),proximal airway viscous resistance(R20)and peripheral elastic resistance(X5)],serum VCAM-1 and CXCL13 levels before and after treatment.Results The total effective rate of the research group was 92.0%,which was significantly higher than 68.0%of the control group,and the difference was statistically significant(P<0.05).After treatment,the Z5,R5,R20,and X5 in the two groups were lower than those before treatment in this group,and the Z5(0.28±0.11)kPa/(L·s),R5(0.30±0.08)kPa/(L·s)in the research group,R20(0.32±0.06)kPa/(L·s),X5(0.86±0.05)kPa/(L·s)in the research group were lower than(0.32±0.04),(0.36±0.07),(0.41±0.07),(0.98±0.20)kPa/(L·s)in the control group.All the differences were statistically significant(P<0.05).After treatment,the levels of serum VCAM-1 and CXCL13 in the two groups were lower than those before treatment in this group,and the serum VCAM-1(425.83±12.52)μg/L and CXCL13(46.83±17.56)pg/ml in the research group were significantly lower than(475.21±11.37)μg/L and(58.35±13.72)pg/ml in the control group.All the differences were statistically significant(P<0.05).The incidence of adverse reactions in the research group was 12.0%,and the difference was not statistically significant when compared with 8.0%in the control group(P>0.05).Conclusion Salbutamol combined with montelukast sodium in the treatment of bronchial asthma is more effective than salbutamol alone,and can more obviously reduce the airway resistance and serum VCAM-1 and CXCL13 levels.