摘要
目的探讨孟鲁司特钠对哮喘-慢阻肺重叠综合征(ACOS)患者肺功能及炎症指标的影响,为患者临床诊疗提供参考。方法选择2016年6月至2018年7月太白县医院内科接诊的72例哮喘-慢阻肺重叠综合征患者作为研究对象,按随机数表法分为观察组和对照组各36例。两组患者均采用常规治疗,对照组在此治疗基础上给予布地奈德治疗,观察组患者则在对照组治疗基础上联合孟鲁司特钠治疗,两组患者均连续治疗2个月,比较两组患者治疗后的临床疗效,以及治疗前后的动脉氧分压(PaO2)、动脉二氧化碳(PaCO2)、血氧饱和度(SpO2)、第一秒最大呼气容积(FEV1)、FEV1与用力肺活量比值(FEV1/FVC)%、最大呼气流量(PEF)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平,并观察两组患者治疗后的不良反应。结果治疗后,观察组患者的临床疗效总有效率为97.22%,明显高于对照组的66.67%,差异有统计学意义(P<0.05);治疗后,观察组患者的PaO2、SpO2水平分别为(77.45±6.13)mmHg,(85.03±12.51)%,明显高于对照组的(71.03±6.22)mmHg、(76.97±12.33)%;PaCO2为(33.68±7.20)mmHg,明显低于对照组的(46.19±7.16)mmHg,差异均有统计学意义(P<0.05);治疗后,观察组患者的FEV1、FEV1/FVC、PEF水平分别为(1.63±0.4)L、(70.55±7.73)%、(3.82±1.03)L/s,明显高于对照组的(1.27±0.31)L、(64.61±6.48)%、(3.15±0.96)L/s,差异均有统计学意义(P<0.05);治疗后,观察组患者的炎症因子CRP、TNF-α和IL-6水平分别为(3.59±0.55)ng/mL,(70.35±3.25)pg/L、(3.19±0.43)pg/L,明显低于对照组的(5.24±0.40)ng/mL,(85.18±3.30)pg/L,(4.42±0.51)pg/L,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为5.56%,略低于对照组的11.11%,但差异无统计学意义(P>0.05)。结论与单独用药比较,孟鲁司特钠联合布地奈德可有效提高ACOS患者的临床疗效,改善肺功能,调节炎症指标,促进患者身体恢复,值得临床推广。
Objective To explore the effect of montelukast sodium on pulmonary function and inflammatory markers in patients with asthma-chronic obstructive pulmonary overlap syndrome(ACOS), and to provide reference for clinical diagnosis and treatment. Methods A total of 72 patients with ACOS, who admitted to Taibai County Hospital from June 2016 to July 2018 were enrolled as the study subjects. According to random number table method, the patients were divided into the observation group and control group, with 36 patients in each group. The patients in both groups were treated with conventional treatment, and the control group was treated with budesonide on the basis of this treatment. The patients in the observation group were treated with montelukast sodium on the basis of the control group. The two groups were treated continuously for 2 months. The clinical effect, the changes of the arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2), blood oxygen saturation(SpO2), respiratory and expiratory volume in the first second(FEV1), FEV1 and forced vital capacity(FEV1/FVC), peak expiratory flow(PEF), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) before and after treatment, the adverse reactions of the two groups were observed. Results After treatment, the total effective rate of the observation group was 97.22%,which was significantly higher than 66.67% of the control group(P<0.05);the level ratio of PaO2 and SpO2 in the observation group were(77.45±6.13) mmHg,(85.03±12.51)%, respectively, which were significantly higher than corresponding(71.03±6.22) mmHg and(76.97±12.33)% in the control group(P<0.05);the PaCO2 was(33.68±7.20) mmHg, which was significantly lower than(46.19 ± 7.16) mmHg in the control group(P<0.05);the pulmonary function FEV1, FEV1/FVC and PEF levels in the observation group were(1.63±0.4) L,(70.55±7.73)%,(3.82±1.03) L/s, respectively, which were significantly higher than corresponding(1.27±0.31) L,(64.61±6.48)%,(3.15±0.9
作者
张莉
张永利
达春水
ZHANG Li;ZHANG Yong-li;DA Chun-shui(Department of Internal Medicine,Taibai County Hospital,Taibai 721600,Shaanxi,CHINA;Department of Critical Care Medicine,Baoji Central Hospital,Baoji 721600,Shaanxi,CHINA;Department of Pediatrics,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第2期163-166,共4页
Hainan Medical Journal
关键词
哮喘-慢阻肺重叠综合征
布地奈德
孟鲁司特钠
肺功能
炎症
不良反应
疗效
Asthma-COPD overlap syndrome(ACOS)
Budesonide
Montelukast sodium
Pulmonary function
Inflammation
Adverse reactions
Efficacy
