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目的探讨白细胞三烯C4(leukotrienes C4,LTC4)与慢性阻塞性肺疾病急性加重期的相关性及孟鲁司特干预治疗的效果。方法 80例慢性阻塞性肺疾病急性加重期患者,随机分为对照组和治疗组各40例,对照组仅行氧疗、抗感染、平喘祛痰等常规治疗,治疗组在常规治疗基础上加用孟鲁司特10mg,1次/d;2组疗程均10d。分别于治疗前、后测定患者血清LTC4水平及第1秒用力呼气容积占预计值的百分比(the percentage of the forced expiratory volume in one second to the predicted value,FEV1%),并进行比较。结果治疗前2组LTC4、FEV1%比较差异无统计学意义(P>0.05);治疗后治疗组LTC4、FEV1%分别为(306.0±176.3)ng/L、66.0±7.4,对照组分别为(489.6±325.2)ng/L、58.9±8.1,与治疗前(治疗组(504.8±339.3)ng/L、51.2±8.4,对照组(519.4±336.3)ng/L、50.4±7.9)比较差异有统计学意义(P<0.05),且治疗组以上指标改善较对照组明显(P<0.05);治疗组FEV1%改善与LTC4下降呈负相关(r=-0.844)。结论慢性阻塞性肺疾病急性加重期患者血清LTC4水平下降与肺功能改善呈负相关,孟鲁司特对患者病情及肺功能的改善作用可能与降低血清LTC4水平有关。
Objective To investigate the correlation between leukotrienes C4 (LTC4) and acute exacerbation of chronic obstructive pulmonary disease (COPD) and the effect of montelukast intervention. Methods A total of 80 patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into control group and treatment group, 40 cases in each group. The control group received conventional therapy such as oxygen therapy, anti-infective, antiasthmatic and expectorant treatment. On the basis of routine treatment Plus montelukast 10mg, 1 / d; 2 groups of treatment were 10d. The patient’s serum LTC4 level and the percentage of the forced expiratory volume in one second to the predicted value (FEV1%) were measured before and after treatment, respectively, and compared. Results There was no significant difference in LTC4 and FEV1% between the two groups before treatment (P> 0.05). After treatment, the LTC4 and FEV1% in the treatment group were (306.0 ± 176.3) ng / L and 66.0 ± 7.4 respectively, while those in the control group were (489.6 ± 325.2 ng / L, 58.9 ± 8.1, which were statistically different from those before treatment (504.8 ± 339.3 ng / L, 51.2 ± 8.4, 519.4 ± 336.3 ng / L, 50.4 ± 7.9) (P <0.05), and the above indexes in the treatment group improved significantly compared with the control group (P <0.05). The improvement of FEV1% in the treatment group was negatively correlated with the decrease of LTC4 (r = -0.844). Conclusions The decline of serum LTC4 in patients with COPD is negatively correlated with the improvement of pulmonary function. The improvement of montelukast on the patient’s condition and pulmonary function may be related to the reduction of serum LTC4 level.