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目的:研究孟鲁司特对老年支气管哮喘合并OSAHS患者呼出气一氧化氮(FeNO)及炎症因子的影响。方法:选取老年支气管哮喘患者150例,筛选经多导睡眠图监测确诊合并OSAHS的患者,分为哮喘合并OSAHS组(n=72)和单纯哮喘组(n=78),两组按照治疗方法不同再分为观察组和对照组。两组均给予止咳、化痰、吸入激素平喘等常规治疗,观察组同时加用孟鲁司特10mg,每晚1次口服。治疗前及治疗1个月后分别行一氧化氮呼出气检测,采血取上清液检测肿瘤坏死因子α(TNR-α)、C反应蛋白(CRP)和IL-6,根据睡眠监测结果计算AHI,对比分析两组患者FeNO水平、CRP、TNR-α、IL-6、AHI的变化情况。结果:治疗前,两组患者性别、年龄、病情程度、FeNO水平、TNR-α、CRP、IL-6、AHI差异无统计学意义(P>0.05)。治疗后两组FeNO水平、TNR-α、CRP、IL-6、AHI较治疗前均下降(P<0.05),且观察组均低于对照组,差异有统计学意义(炎症因子P<0.05,AHI、FeNO水平P<0.01)。结论:孟鲁司特可降低老年支气管哮喘合并OSAHS患者的TNR-α、CRP、IL-6、AHI和FeNO水平,可为老年支气管哮喘合并OSAHS患者的临床用药提供参考。
Objective: To study the effects of montelukast on exhaled nitric oxide (NO) and inflammatory cytokines in aged patients with bronchial asthma and OSAHS. Methods: A total of 150 elderly patients with bronchial asthma were enrolled in this study. Patients with OSAHS diagnosed by polysomnography were selected and divided into two groups according to the different treatment methods: asthma combined with OSAHS group (n = 72) and simple asthma group (n = 78) Divided into observation group and control group. Both groups were given conventional treatment of cough, phlegm, inhaled steroid and asthma, while the observation group was given montelukast 10 mg orally once night. Nitric oxide exhaled breath was measured before treatment and 1 month after treatment. Tumor necrosis factor alpha (TNR-α), C-reactive protein (CRP) and IL-6 were measured by blood sampling and the AHI The levels of FeNO, CRP, TNR-α, IL-6 and AHI in two groups were compared and analyzed. Results: There was no significant difference in gender, age, severity of illness, level of FeNO, TNR-α, CRP, IL-6 and AHI between the two groups before treatment (P> 0.05). The levels of FeNO, TNR-α, CRP, IL-6 and AHI in the two groups after treatment were significantly lower than those before treatment (P <0.05), and the levels in the observation group were lower than those in the control group AHI, FeNO level P <0.01). Conclusion: Montelukast can reduce the levels of TNR-α, CRP, IL-6, AHI and FeNO in elderly patients with bronchial asthma combined with OSAHS, which may provide a reference for the clinical use of bronchial asthma in patients with OSAHS.