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观察顺尔宁联合酮替芬治疗伴气道高反应性的慢性阻塞性肺疾病急性加重期的疗效及其对Th17/Treg的影响

Observation of the Effect of Singulair Combined With Ketotifen in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease With Airway Hyperresponsiveness and Its Influence on Th17/Treg.

作者信息

Wang Haiou, Qu Gaojie

机构信息

The Third Affiliated Hospital, Department of Respiratory Medicine, Hengyang Medical School, University of South China, Hengyang, China.

出版信息

Front Surg. 2022 Feb 28;9:848724. doi: 10.3389/fsurg.2022.848724. eCollection 2022.

Abstract

OBJECTIVE

To investigate the effect of montelukast sodium (singulair) combined with ketotifen fumarate on the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with airway hyperresponsiveness (AHR) and its effect on helper T cells 17 (Th17)/regulator T cells (Treg).

METHODS

168 patients with AECOPD and AHR diagnosed in our hospital from February 2018 to December 2019 were selected, and divided into the observation group ( = 84) and the control group ( = 84). Both groups were given anti infection, bronchodilator, glucocorticoid, phosphodiesterase inhibitor, cough and expectorant. The observation group was additionally treated with singulair tablets and ketotifen tablets for 14 days. The curative effect were observed after treatment. The first second forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1 as percentage of predicted value (FEV1% pred), blood oxygen pressure (PaO) and blood carbon dioxide pressure (PaCO), high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT), Th17 and Treg levels were measured in both groups before and after treatment.

RESULTS

Compared with the control group, the total effective rate after treatment in the observation group was increased (94.05 vs. 75.00%, < 0.05). Compared with before treatment, the FEV1, FVC and FEV1%pred levels of the two groups of patients after treatment were increased ( < 0.05). Compared with the control group, the FEV1, FVC and FEV1%pred levels of the observation group were increased after treatment ( < 0.05). Compared with before treatment, the PaCO2, hs-CRP and PCT levels of the two groups of patients were reduced after treatment, and PaO2 levels were increased ( < 0.05). Compared with the control group, the PaCO2, hs-CRP and PCT levels in the observation group were reduced after treatment, and the PaO2 level was increased ( < 0.05). Compared with before treatment, Th17 and Th17/Treg levels of the two groups of patients were reduced after treatment, and Treg levels were increased ( < 0.05). Compared with the control group, the Th17 and Th17/Treg levels of the observation group were reduced after treatment, and the Treg levels was increased ( < 0.05).

CONCLUSION

Singulair combined with ketotifen in the treatment of patients with AECOPD combined with AHR can significantly improve the efficacy, improve lung function, reduce inflammatory response, and improve the balance of Th17/Treg, effectively controlling the disease.

摘要

目的

探讨孟鲁司特钠(顺尔宁)联合富马酸酮替芬对伴有气道高反应性(AHR)的慢性阻塞性肺疾病急性加重期(AECOPD)的影响及其对辅助性T细胞17(Th17)/调节性T细胞(Treg)的作用。

方法

选取2018年2月至2019年12月在我院诊断为AECOPD且伴有AHR的168例患者,分为观察组(n = 84)和对照组(n = 84)。两组均给予抗感染、支气管扩张剂、糖皮质激素、磷酸二酯酶抑制剂、止咳祛痰药。观察组加用顺尔宁片和酮替芬片治疗14天。治疗后观察疗效。测定两组治疗前后第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1占预计值百分比(FEV1%pred)、血氧分压(PaO₂)、血二氧化碳分压(PaCO₂)、高敏C反应蛋白(hs-CRP)、降钙素原(PCT)、Th17和Treg水平。

结果

与对照组相比,观察组治疗后总有效率升高(94.05% vs. 75.00%,P < 0.05)。与治疗前相比,两组患者治疗后FEV1、FVC和FEV1%pred水平升高(P < 0.05)。与对照组相比,观察组治疗后FEV1、FVC和FEV1%pred水平升高(P < 0.05)。与治疗前相比,两组患者治疗后PaCO₂、hs-CRP和PCT水平降低,PaO₂水平升高(P < 0.05)。与对照组相比,观察组治疗后PaCO₂、hs-CRP和PCT水平降低,PaO₂水平升高(P < 0.05)。与治疗前相比,两组患者治疗后Th17和Th17/Treg水平降低,Treg水平升高(P < 0.05)。与对照组相比,观察组治疗后Th17和Th17/Treg水平降低,Treg水平升高(P < 0.05)。

结论

顺尔宁联合酮替芬治疗AECOPD合并AHR患者可显著提高疗效,改善肺功能,减轻炎症反应,改善Th17/Treg平衡,有效控制病情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60cd/8918495/81e82935c4f9/fsurg-09-848724-g0001.jpg

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