白三烯受体拮抗剂对支气管扩张症急性期患者气道黏液高分泌的影响

发布时间：2018-03-04 09:05

本文选题：白三烯受体拮抗剂　切入点：支气管扩张症　出处：《中国呼吸与危重监护杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨白三烯受体拮抗剂孟鲁司特对支气管扩张症急性期患者痰液理化性质以及气道黏液高分泌的影响。方法将84例支气管扩张症急性期患者采用数字随机法分为试验组及对照组,每组42例。对照组予以常规治疗,试验组在对照组的基础上加用孟鲁司特10 mg睡前口服连续2周。观察入院第1 d及第15 d患者24 h痰量、痰液的干/湿重比值、黏度以及中性粒细胞弹性蛋白酶(NE)和黏蛋白MUC5ac含量(酶联免疫吸附法),同期测定肺通气功能、气道阻力及血气分析。结果两组患者治疗后每日痰量、干/湿重比值、黏度、NE、MUC5ac含量、肺通气功能、血气分析及气道阻力指标均较治疗前有明显下降或好转(P0.05)。试验组治疗后的每日痰量[(5.62±1.83)g vs.(7.53±2.32)g]、NE水平[(3.85±0.97)μg/ml vs.(4.54±1.03)μg/ml]、MUC5ac蛋白含量[(0.65±0.21)μg/ml vs.(0.82±0.29)μg/ml]以及气道阻力[(119.16±11.76)%vs.(128.37±12.08)%]均较对照组显著下降(P0.05)。痰黏度在治疗后两组间无明显差异。结论孟鲁司特能减少支急性期支气管扩张症患者的痰量并降低气道阻力,可能通过NE下调气道黏蛋白MUC5ac表达,具有抑制气道黏液高分泌的作用。
[Abstract]:Objective to investigate the effects of montelukast, a leukotriene receptor antagonist, on the physiochemical properties of sputum and airway mucus hypersecretion in acute bronchiectasis patients. Divided into experimental group and control group, 42 patients in each group were treated with routine therapy. The experimental group was given montelukast 10 mg orally for 2 weeks before bedtime. The sputum volume and the dry / wet weight ratio of sputum were observed on the 1st and 15th day after admission. Viscosity, neutrophil elastase (NEN) and mucin MUC5ac (enzyme linked immunosorbent assay) were used to measure pulmonary ventilation function, airway resistance and blood gas. The content of MUC5ac, pulmonary ventilation function, The blood gas analysis and airway resistance index were significantly decreased or improved compared with those before treatment. The daily phlegm volume after treatment [5.62 卤1.83 vs.(7.53 卤2.32 g] NE in the experimental group [3.85 卤0.97 渭 g / ml vs.(4.54 卤1.03 渭 g / ml] MUC5ac protein content [0.65 卤0.21 渭 g / ml vs.(0.82 卤0.29 渭 g / ml] and airway resistance [119.16 卤11.76vs.128.37 卤12.08%] were significantly lower than those in the control group. Conclusion Montelukast can reduce sputum volume and airway resistance in bronchiectasis patients in acute bronchiectasis. It may be that NE down-regulates airway mucin MUC5ac expression and inhibits airway mucus hypersecretion.
【作者单位】：核工业四一六医院呼吸内科;
【分类号】：R562.22

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