| 中重度稳定期慢性阻塞性肺疾病患者尿白三烯E4测定及临床意义 |
| 投稿时间：2016-05-15 修订日期：2016-07-05 点此下载全文 |
| 引用本文：刘海玲,胡苏萍,聂汉祥,张固琴.中重度稳定期慢性阻塞性肺疾病患者尿白三烯E4测定及临床意义[J].医学研究杂志,2017,46(2):119-122,36 |
| DOI：
10.11969/j.issn.1673-548X.2017.02.031 |
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| 中文摘要:目的 探讨白三烯E4在中重度稳定期慢性阻塞性肺疾病（chronic obstructive pulnonary disease，COPD）发病机制中的作用，及白三烯受体拮抗剂治疗的临床疗效。方法 将60例中重度稳定期COPD患者随机分为孟鲁司特组及常规治疗组各30例，取30例健康患者为对照组。观察3个月治疗前后各组尿白三烯E4（uLTE4）水平、肺功能（PFT）、短效β2受体激动剂使用剂量、健康相关生活质量（HRQL）评分变化。同时研究第1秒时间肺活量（FEV1）与uLTE4、HRQL评分相关性。结果 孟鲁司特组治疗后肺功能参数用力肺活量（FVC）、第1秒钟用力呼气量（FEV1）、1秒量占预计值的百分比（FEV1% pre）均较治疗前明显提高（P均<0.05），HRQL评分均明显低于治疗前（P均<0.01），β2受体激动剂使用剂量较治疗前显著减少（P<0.05）；治疗后孟鲁司特组uLTE4水平显著低于治疗前（P<0.05）；常规治疗组治疗前后uLTE4水平无明显改变，差异无统计学意义（P>0.05）。FEV1与uLTE4，HRQL评分均呈负相关（r分别为-0.67、-0.73，P<0.05）。结论 白三烯在慢性阻塞性肺疾病发病中可能起了重要的作用，检测尿液LTE4水平对于了解慢性阻塞性肺疾病患者体内白三烯水平，以及评价白三烯受体拮抗剂的疗效具有一定的临床意义。孟鲁司特长期使用可改善中重度稳定期COPD患者生活质量，肺功能及减少β2受体激动剂使用剂量。 |
| 中文关键词:尿白三烯E4 慢性阻塞性肺疾病 孟鲁司特 |
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| Detection of Urinary Leukotriene E4 in Patients with Moderate to Severe Stable Chronic Obstruetive Pulmonary Disease and Its Clinical Significance |
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| Abstract:Objective To explore the role of Leukotriene in pathogenesis of moderate-to-severe stable chronic obstructive pulmonary disease(COPD) and evaluate clinical efficacy of leukotriene receptor antagonist to the patients of COPD. Methods Sixty patients with moderate-to-severe stable COPD and thirty healthy subjects were enrolled in the study. The patitents of COPD were randomized into conventional therapy group(n=30) and montelukast group(n=30). Oxygen therapy, administration of expectorant and salbutamol inhalation were given to the conventional therapy group. Montelukast were added to the montelukast group besides the conventional therapy. The study lasts three months. Pulmonary function test(FEV1,FVC,FEV1% pre),β2-agonist dosage, the score of health-related quality of life(HRQL) and urinary leukotriene E4(uLTE4) were measured before and after treatment. The relationship of FEV1, the level of urinary leukotriene E4 and the scores of HRQL were evaluated. Results In the montelukast group, after treatment. FVC、FEV1 and FEV1% were significantly elevated(P<0.05), and the HRQL scores decresed obviously(P<0.01). Meanwhile, the dosage of β2-agonist used decreaed significantly after treatment than before(P<0.05). There was no significant difference of those items in the conventional therapy group(P>0.05). Before treatment, the contents of uLTE4 in the montelukast group and conventional therapy group were obviously higher than that in healthy control group(P<0.05) and there were no significant difference between montelukast group and conventional therapy group(P>0.05). The contents of uLTE4 in the montelukast group declined obviously after treatment(P<0.05). There was no difference in the conventional therapy group before and after treatment(P>0.5). There was significantly negative correlation among FEV1, the levels of uLTE4 and the scores of HRQL(P<0.05). Conclusion Leukotriene might play an important role in the pathogenetic process of COPD. Detection of LTE4 in the urine of patients with COPD may be useful in evaluating therapeutic effect of leukotriene receptor antagonist. Montelukast that is used as additionally drug besides routine treatment protocol can take improvement on PFT, and HRQL and may reduce the usge of β2-agonistdosage in patients with moderate to severe stable COPD. |
| keywords:Urinary leukotrien E4 Chronic obstructive pulmonary disease(COPD) Montelukast |
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