摘要
目的:探讨噻托溴铵联合孟鲁思特治疗对慢性阻塞性肺疾病(COPD)患者血液流变学、肺功能及血清细胞因子水平的影响。方法:选取82例在本院进行诊治并接受住院治疗的COPD患者,随机分为对照组和观察组,每组41例。所有患者均根据具体情况给予对症常规治疗方案,同时在对症治疗的基础上每晚给予对照组口服10mg孟鲁司特钠1次,在此基础上每晚给予观察组吸入18μg噻托溴铵。所有患者均治疗4周,于治疗前后对两组的血液流变指标、肺功能指标以及血清细胞因子进行测定和比较。结果:(1)血液流变学指标:治疗前两组血液流变学指标全血黏度(高切、中切、低切)、血浆黏度、红细胞压积、纤维蛋白原之间相比,差异均无统计学意义(P>0.05);治疗后两组血液流变学相关指标均明显低于同组治疗前,且观察组血液流变学相关指标下降水平明显优于对照组,差异均具有统计学意义(P<0.05);(2)肺功能指标:治疗前两组肺功能指标FVC、FEV1、MMEF、PEF之间相比,差异均无统计学意义(P>0.05);治疗后两组肺功能相关指标均明显高于同组治疗前,且观察组肺功能相关指标水平均明显高于同期对照组,差异均具有统计学意义(P<0.05);(3)血清细胞因子:治疗前两组血清细胞因子IL-10、IL-18、APN水平之间相比,差异无统计学意义(P>0.05);治疗后两组血清IL-10、APN水平明显升高,IL-18水平明显降低,且与对照组相比,观察组血清IL-10、APN水平明显升高,IL-18水平明显降低,差异均具有统计学意义(P<0.05)。结论:对COPD患者联合应用噻托溴铵和孟鲁思特进行治疗,不仅可以明显改善患者的血液流变学指标,而且可以显著控制血清细胞因子水平,控制症状,改善肺功能,值得临床上进一步推广应用。
Objective： To examine the effects of Tiotropium Bromide combined with Montelukast on COPD patients＇ blood ＇theology, pulmonary function and serum cytokine levels. Methods： A total of 82 COPD patients who were treated in our hospital were divided into control group and observation group randomly with 40 cases in each graoup. All patients were given symptomatic and conventional treatment according to the specific circumstances, patients in the control group were treated with 10 mg Montelukast with orally once per night on the basis of conventional treatment, and observation group patients was given 18 gg Tiotropium Bromide inhalation once per night on the basis of control group. All the patients were treated for 4 weeks, the blood theology indexes, pulmonary function indexes and serum cytokines were measured and compared between the two groups before and after treatment. Results.. （1）Blood rheological indicators： before treatment, there was no significant differ- ence in blood theology index of whole blood viscosity（high shear viscosity, shear viscosity, low shear viscosity）, plasma vis- cosity, hematocrit and fibrinogen（P 〉0.05） After treatment, the blood rheology indexes of the two groups were significantly decreased compared with that in the same group before treatment, and the difference was statistically significant （P 〈0.05）. Meanwhile, the related indexes of blood rheology in observation group were significantly better than the control group, the difference was statistically significant（P〈0.05） ; （2）Lung function indexes： Before treatment,there was no significant differ- ence in Lung function indexes of FVC,FEV1 ,MMEF,PEF （P〉0.05）. After treatment, the indexes of pulmonary function in the two groups were significantly higher than that in the same group before treatment, the difference was significant（P〈0.05）. Meanwhile, the level of lung function in the observation group were significantly higher than that in the control group, the difference was significant（P 〈0.05） ;（3）Cell factors： Before treatment, there was no significant difference in cell factors of ser- um IL- 10, IL- 18, APN（P 〉0.05 ） ; After treatment, the two groups＇ serum IL-10, APN levels were significantly increased, IL-18 levels were significantly reduced, and the differences were statistically significant （P 〈0.05）.Meanwhile, serum IL-10, APN levels in Observation group were significantly increased, IL-18 levels were significantly lower than that in control group, and the difference was statistically significant （P〈0.05）. Oonclusion： The comibinition of Tiotropium bromide with montelu- kas not only can improve the indexes of blood rheology in patients with COPD, and can significantly control the level of serum cytokines and control symptoms, improve lung function, so it is worth further clinical application.
出处
《海南医学院学报》
CAS
2016年第22期2703-2706,共4页
Journal of Hainan Medical University
基金
2014年度湖北省自然科学基金(鄂科技发计[2010]11号)~~
