白三烯受体拮抗剂对乙酰甲胆碱支气管激发试验剂量-反应曲线参数的影响

目的　探讨白三烯受体拮抗剂扎鲁斯特对乙酰甲胆碱支气管激发试验剂量 -反应曲线参数的影响。方法　对 2 0例咳嗽变异型哮喘 (CVA)、2 0例哮喘患者进行白三烯受体拮抗剂的临床研究 ,以 4例 CVA,10例哮喘患者为对照。对治疗前后乙酰甲胆碱支气管激发试验剂量 -反应曲线各参数 ,包括反应阈值 (PC35 s Gaw )、剂量 -反应曲线斜率 (DRS)、曲线下面积与最末浓度对数之比 (AUC/ lgCm ax])、最大反应平台进行了测定。结果　白三烯受体拮抗剂显著增加 CVA组与哮喘组的 PC35 s Gaw,显著降低 CVA组的 DRS与 AUC/ lgCm ax];但对哮喘组 DRS与 AU C/ lgCmax]无影响 ,对 CVA组和哮喘组的平台有无及平台高度均无影响。结论　短期应用白三烯受体拮抗剂可改善哮喘患者乙酰甲胆碱支气管激发试验剂量 -反应曲线参数。

The Effect of Leukotriene Antagonist on the Parameters of Dose-response Curve Obtained after Methacholine Challenge Test

Objective To investigate the effect of leukotriene antagonist (zafirlucast) on the parameters of dose response curve (DRC) obtained after methacholine challenge test. Methods A therapy trial was conducted with the use of zafirlucast in 20 cases of cough variant asthma (CVA) and 20 cases of asthma.Placeba was used in 4 cases of CVA and 10 cases of asthma for comparison with the two therapy groups respectively. Before and after the zafirlucast treatment a series of parameters of DRC were obtained after the methacholine challenge test and were calculated.These included the response threshold (PC35sGaw), the dose response slope (DRS), the ratio of the area under the curve to the logarithm of the maximal concentration (AUC/lgCmax]), and the maximal response. Results Zafirlucast significantly increased the PC35sGaw in the CVA and asthma groups. It conspicuously decreased all the parameters of DRS and AUC/1gCmax] except for maximal response in the cases of CVA, and it had no significant effects on all the parameters of DRS and AUC/1gCmax] except for PC35sGaw in the cases of asthma.Conclusion Short term use of Zafirlucast in asthmatic patients could improve the parameters of dose response curve obtained after the methacholine challenge test.