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目的:研究白三烯拮抗剂孟鲁司特钠联合舒利迭对支气管哮喘患者肺功能的改善作用以及对细胞因子IFN-γ、IL-12、IL-13的影响。方法:2008年9月-2011年8月义乌市第二人民医院呼吸科就诊的支气管哮喘患者60例随机分为对照组和观察组。对照组患者吸入舒利迭,每天2次。观察组患者吸入舒利迭,每天2次;口服孟鲁司特钠,每次10mg,每天1次。两组患者疗程均为4周。治疗前及治疗4周测定两组患者的肺功能(FEV1、PEF和FVC)以及外周血清细胞因子IFN-γ、IL-12、IL-13水平。结果:治疗4周时两组患者的FEV1、PEF、FVC和FEV1/FVC均较治疗前显著升高(P<0.01);并且两组FEV1、PEF和FVC差异具有统计学意义(P<0.01)。治疗后两组患者血清IL-12和IFN-γ升高(P<0.01),血清IL-13降低(P<0.01);并且两组差异具有统计学意义(P<0.01)。结论:白三烯拮抗剂孟鲁司特钠联合吸入舒利迭在改善支气管哮喘患者的肺功能方面优于单用吸入舒利迭,可能与其降低血清IL-13、IFN-γ水平以及升高IL-12水平有关。
Objective: To investigate the effects of leukotriene antagonist montelukast sodium combined with seretide on pulmonary function in patients with bronchial asthma and its effects on cytokines IFN-γ, IL-12 and IL-13. Methods: From September 2008 to August 2011, 60 patients with bronchial asthma admitted to Respiratory Department of Second People’s Hospital of Yiwu City were randomly divided into control group and observation group. Control patients inhaled seretide, twice daily. Observation group patients inhaled seretide, 2 times a day; oral montelukast sodium, each 10mg, 1 times a day. Two groups of patients were treated for 4 weeks. The pulmonary function (FEV1, PEF and FVC) and the levels of peripheral serum cytokines IFN-γ, IL-12 and IL-13 were measured before and 4 weeks after treatment. Results: The FEV1, PEF, FVC and FEV1 / FVC of the two groups were significantly higher than those before treatment at 4 weeks (P <0.01), and the differences of FEV1, PEF and FVC between the two groups were statistically significant (P0.01) . Serum levels of IL-12 and IFN-γ in the two groups increased (P <0.01) and serum IL-13 decreased after treatment (P <0.01), and the difference between the two groups was statistically significant (P <0.01). Conclusion: Leukotriene antagonist combination of montelukast and inhaled seretide is superior to inhaled seretide alone in improving lung function in patients with bronchial asthma, which may be related to the decrease of serum IL-13 and IFN-γ level IL-12 levels related.