孟鲁司特对哮喘患者可溶性白介素2受体及肿瘤坏死因子α表达水平影响.doc

孟鲁司特对哮喘患者可溶性白介素2受体及肿瘤坏死因子α表达水平影响 　　【摘要】 目的探讨孟鲁司特通过影响SIL-2R和TNF-α的表达从而引发哮喘患者体内巨噬细胞和T细胞的抗炎症反应的机制。为临床选择用药提供指导。 方法 对48例轻中度稳定期哮喘患者进行8周孟鲁司特治疗试验，同时选取48列正常成人作为对照。试验前后均测定其1 秒量(FEV1)值。同时测定血清中SIL-2R、TNF-α及嗜酸粒细胞阳离子蛋白水平。结果 药物治疗后，嗜酸粒细胞阳离子蛋白量明显降低(32．1±11．8 VS 20．2±11．2,P0．01),FEV1显著升高(78．9±10．9 VS 103±13．7,P0．05)。蛋白水平和检测显示：患者治疗前SIL-2R表达量均显著高于治疗后(1034．77±175．18,773±230．19,P0．05)及对照组(571．11±123．12; P0．01)TNF-α表达水平治疗前亦显著高于治疗后与对照组(8．60±1．79,5．89±2．16,5．10±1．07; P0．05)。Spearman 相关分析法分析后显示孟鲁司特疗效与SIL-2RuL及TNF-α TE4 有相关性。结论 我们的研究显示，孟鲁司特通过降低SIL-2R与TNF-α的表达水平从而引发抗炎症反应。同时，SIL-2R与TNF-α的表达水平亦与孟鲁司特临床疗效密切相关,可作为选择此类药物的参考标志物。 　　【关键词】孟鲁司特；哮喘；白介素-2受体；肿瘤坏死因子α 　　 　　Study of the effect of Montelukast on soluble interleukin-2 receptor and tumor necrosis factor α in asthmatic patients 　　 　　CHEN Guang-jun,TIAN Ying.The People’s second Hosptal of Yueyang，Yueyang 414000，China 　　 　　【Abstract】 Objective To investigate the anti-inflammatory response of montelukast on macrophage and T-cell activation by sIL-2R and TNF-α in asthmatic patients for the further decision of pharmacologic scheme in clinical medication.Methods 48 patients with midrangestablephasasthmaweretreated montelukast for 8 weeks.And 48 healthy volenteers(control group)were enrolled.Lung function test forced expiratory volume in 1 second(FEV1)was performed before and after treatment.Serum SIL-2R,TNF-α,and eosinophil cationic protein levels were determined in the control group and in asthmatic patientes before and after treatment.Results The mean eosinophil cationic protein value was significantly decreased(32．1±11．8 VS 20．2±11．2,P0．01)and FEV1 was significantly increased(78．9±10．9 VS 103±13．7,P0．05)after 8 weeks’ treatment with montelukast.The mean serum IL-2R levels were significantly higher in the before-treatment group than that in the after-treatment group(1034．77±175．18,773±230．19,P0．05)or in control subjects(571．11±123．12; P0．01).The mean serum TNF-α level was higher in the before-treatment group than that in the after-treatment g