联合治疗方案对COPD患者炎症因子及血液生化指标的影响

目的研究舒利迭联合孟鲁司特对慢性阻塞性肺疾病（COPD）患者炎症因子及血液生化指标的影响。方法筛选2011年6月-2012年10月间来笔者医院呼吸内科就诊的COPD患者79例，随机分为舒利迭单独给药组（n=41）和舒利迭联合孟鲁司特的联合单药组（n=38）。观察所有患者治疗前后炎症因子（sICAM-1、IL-6、IL-8、IL-10、IL-17）及其他血液生化指标（Hb、Glu、PaO2、AG、HC03-、PaCO：）的变化情况。结果在炎症因子方面，单药组治疗前后各炎症因子比较差异均有统计学意义（P〈0．05），而联合组治疗前后各指标比较差异也有统计学意义（P〈0．01）。组问比较联合组在IL-6、IL-8和IL-17指标上均较单药组有统计学差异（P〈0．05）。在生化指标方面，治疗前后比较，单药组仅HC03-、PaO：和PaCO：的改变有统计学意义（P〈0．05），而联合组还能有效降低AG在血浆中的水平（P〈0．05）。组间比较联合组在HC03-、PaO：和PaCO：指标上均较单药组有显著性差异（P〈0．05）。结论舒利迭联合孟鲁司特用药可更加有效的促进患者炎症因子水平下降和生化指标的明显改善。

Effect of Combination Treatment Strategy on Inflammatory Factors and Blood Biochemical Indexes in COPD Patients.

Objective To study the effect of Seretide combined with Montelukast for COPD patients on inflammatory factors and blood biochemical indexes. Methods Seventy nine COPD patients screened between June 2011 and October 2012 that came to our hospi- tal for respiratory medicine treatment were randomly divided into Seretide administered Mone （ n = 41 ） and combined montelukast Seretide joint single drug group （n = 38）. Changes of inflammatory factors （ slCAM - 1, IL - 6, IL - 8, IL - 10, IL - 17） and other blood bio- chemical parameters （Hb, Glu, PaO2 , AG, HCO3 - , PaCO~） in all patients before and after treatment were observe. Results The in- flammatory factors of monotherapy group before and after treatment had statistically significant differences （ P 〈 0.05 ）, while the indicators of combination group before and after treatment also had statistically significant difference （P 〈 O. 01 ）. Between the two groups, the com- bined group were significantly better in indicators of IL - 6, IL - 8 and IL - 17 than monotherapy group （ P 〈 0.05 ）. On biochemical indi- cators before and after treatment, only HCO3 - , PaO2 and PaCO2 changes in monotherapy group were statistically significant （P 〈 0.05） , while the combined group can effectively reduce AG in plasma levels eighter （P 〈 0.05 ）. Between the two groups, combined group had significant difference in indicators of HCO3 - , PaO2 and PaCO： compared with monotherapy group （P 〈 0.05）. Conclusion Seretide plus montelukast therapy may be more effective in decreasing levels of inflammatory factors and improving biochemical indicators signifi- cantly.