孟鲁司特联合噻托溴铵对COPD患者血清细胞因子、血液流变学及肺功能的影响

目的 探讨孟鲁司特联合噻托溴铵对慢性阻塞性肺疾病（COPD）患者血清APN、IL-10、TNF-α水平、血液流变学及肺功能的影响。方法 将2016年12月~2018年12月于我院就诊COPD的84例患者纳入研究，随机分为对照组和观察组，每组42例。对照组给予噻托溴铵治疗，观察组给予孟鲁司特联合噻托溴铵治疗。比较两组治疗前后的血清脂联素（APN）、白介素 10（IL-10）、肿瘤坏死因子α（TNF-α），肺功能指标，血液流变学指标。结果 治疗后两组血清APN、IL-10、TNF-α水平下降，且观察组低于对照组，差异有统计学意义（P＜0.05）；治疗后两组用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、每分钟最大通气量（MVV）均上升，且观察组优于对照组，差异有统计学意义（P＜0.05）；治疗后两组纤维蛋白原、红细胞压积、血浆黏度下降，且观察组低于对照组，差异有统计学意义（P＜0.05）。结论 孟鲁司特联合噻托溴铵治疗COPD有助于改善血清APN、IL-10、TNF-α水平、血液流变学指标，促进肺功能的恢复，提高生活质量，具有一定临床应用价值。

Effect of Montelukast Combined with Tiotropium Bromide on Serum Cytokines,Hemorheology and Lung Function in Patients with COPD

Objective To investigate the effects of montelukast combined with tiotropium bromide on serum APN, IL-10, TNF-α levels, hemorheology and pulmonary function in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 84 patients with COPD who were treated in our hospital from December 2016 to December 2018 were included in the study and randomly divided into a control group and an observation group, with 42 patients in each group. The control group was treated with tiotropium bromide, and the observation group was treated with montelukast combined with tiotropium bromide. The serum adiponectin (APN), interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α), lung function index, and hemorheology index were compared between the two groups before and after treatment.Results After treatment, the levels of serum APN, IL-10, and TNF-α decreased in the two groups, and the observation group was lower than the control group,the difference was statistically significant(P<0.05);Forced vital capacity (FVC), forced expiratory volume (FEV1), and maximum ventilation per minute (MVV) in the two groups increased after treatment, and the observation group was better than the control group,the differences were statistically significant(P<0.05); After treatment, the fibrinogen, hematocrit, and plasma viscosity of the two groups decreased, and the observation group was lower than the control group,the differences were statistically significant (P<0.05).Conclusion Montelukast combined with tiotropium bromide in the treatment of COPD can improve serum APN, IL-10, TNF-α levels, hemorheology indexes, promote pulmonary function recovery, improve quality of life, and have certain clinical application value.