孟鲁司特联合异丙托溴铵治疗重症哮喘的有效性及对PEF、FEV1、FEV1/FVC的影响

魏娟 孙延玲 王会玲

【摘要】 目的：探討孟鲁司特联合异丙托溴铵治疗重症哮喘的有效性及对PEF、FEV1、FEV1/FVC的影响。方法：选取2019年3月-2020年3月在本院接受治疗的重症哮喘患者106例。随机分为对照组和研究组，每组53例。对照组应用孟鲁司特治疗，研究组应用孟鲁司特联合异丙托溴铵治疗。比较两组患者的治疗效果和PEF、FEV1、FEV1/FVC、IgE、IL-5、IL-10水平、复发及不良反应发生情况。结果：研究组的总有效率为96.2%，优于对照组的75.5%，差异有统计学意义（P<0.05）。治疗后，研究组的PEF、FEV1、FEV1/FVC均高于对照组，差异均有统计学意义（P<0.05）。治疗后，研究组IgE、IL-5均低于对照组，IL-10高于对照组，差异均有统计学意义（P<0.05）。研究组复发率、不良反应发生率均低于对照组，差异均有统计学意义（P<0.05）。结论：应用孟鲁司特联合异丙托溴铵对重症哮喘患者进行治疗，具有显著疗效，不仅能明显改善患者的肺功能水平，还能降低炎性因子水平，安全性高，见效快， 临床上值得进一步应用推广。

【关键词】 重症哮喘 孟鲁司特 异丙托溴铵 有效性 PEF FEV1 FEV1/FVC

Efficacy of Montelukast Combined with Ipratropium Bromide in the Treatment of Severe Asthma and Its Influence on PEF， FEV1， FEV1/FVC/WEI Juan， SUN Yanling， WANG Huiling. //Medical Innovation of China， 2021， 18（13）： 0-043

[Abstract] Objective： To investigate the efficacy of Montelukast combined with Ipratropium Bromide in the treatment of severe asthma and its effect on PEF， FEV1， FEV1/FVC. Method： A total of 106 patients with severe asthma who received treatment in our hospital from March 2019 to March 2020 were selected. They were randomly divided into control group and study group， 53 cases in each group. The control group was treated with Montelukast and the study group with Montelukast combined with Ipratropium Bromide. The therapeutic effect， PEF， FEV1， FEV1/FVC， levels of IgE， IL-5， IL-10， recurrence and the incidence of adverse reactions in two groups were compared. Result： The total effective rate of the study group was 96.2%， better than 75.5% of the control group， the difference was statistically significant （P<0.05）. After treatment， the PEF， FEV1 and FEV1/FVC in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. After treatment， both IgE and IL-5 in the study group were lower than those in the control group， and IL-10 was higher than those in the control group， the differences were statistically significant （P<0.05）. The recurrence rate and incidence of adverse reactions in the study group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The application of Montelukast combined with Ipratropium Bromide in the treatment of severe asthma patients has a significant effect， which can not only significantly improve the level of lung function of patients， but also reduce the level of inflammatory factors， with high safety and quick effect， and it is worthy of further application and promotion in clinical practice.

[Key words] Severe asthma Montelukast Ipratropium Bromide Efficacy PEF FEV1 FEV1/FVC

First-authors address： Laiwu Peoples Hospital， Jinan 271100， China

doi：10.3969/j.issn.1674-4985.2021.13.010

近年来，伴随着工业化进程的加速，环境气候的变化，有关于重度哮喘的发病率呈逐年增长的趋势[1]。重度哮喘会致使患者出现气道痉挛和呼吸困难的现象，严重影响患者的日常生活与工作[2]。在支气管哮喘中，可依据病情划分四种哮喘程度，主要是轻度、中度、重度以及危重，重症哮喘主要包括重度与危重[3]。在临床上，重症哮喘通常是指当哮喘持续发作1 d以上，而且应用常规方法治疗之后，病情仍得不到缓解，患者在静息状况下，发生语言受限、呼吸困难、浅快等现象[4]。如果重症哮喘患者没有得到及时有效的治疗，那么死亡率极高[5-6]。本院在治疗重症哮喘患者时，应用孟鲁司特联合异丙托溴铵治疗，获得理想效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2019年3月-2020年3月在本院接受治疗的重症哮喘患者106例。（1）纳入标准：①经过各项检查，确诊为重症哮喘;②一般资料完整。（2）排除标准：①合并高血压、糖尿病者;②合并其他心、肝、肾等疾病者;③严重呼吸道感染者;④免疫系统疾病者;⑤对本研究所用药物过敏者;⑥妊娠及哺乳期妇女;⑦精神障碍和认知障碍的患者。……