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1、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±11．8VS20．2±11．2,P<0．01),FEV1显著
2、升高(78．9±10．9VS103±13．7,P<0．05)。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,P<0．05)及对照组(571．11±123．12;P<0．01)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;P<0．05)。Spearman相关分析法分析后显示孟鲁司特疗效与SIL-2RuL及TNF-αTE4有相关性。结论我们的研究显示，孟鲁司特通过降低SIL-2R与TN
3、F-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。12【关键词】孟鲁司特；哮喘；白介素-2受体；肿瘤坏死因子αStudyoftheeffectofMontelukastonsolubleinterleukin-2receptorandtumornecrosisfactorαinasthmaticpatientsCHENGuang-jun,TIANYing.ThePeople’ssecondHosptalofYueyang，Yue
4、yang414000，China【Abstract】ObjectiveToinvestigatetheanti-inflammatoryresponseofmontelukastonmacrophageandT-cellactivationbysIL-2RandTNF-αinasthmaticpatientsforthefurtherdecisionofpharmacologicschemeinclinicalmedication.Methods48patientswithmidrangestablephasast
5、hmaweretreatedmontelukastfor8weeks.And48healthyvolenteers(controlgroup)wereenrolled.Lungfunctiontestforcedexpiratoryvolumein1second(FEV1)wasperformedbeforeandaftertreatment.SerumSIL-2R,TNF-α,andeosinophilcationicproteinlevelsweredeterminedinthecontrolgroupandi
6、nasthmaticpatientesbeforeandaftertreatment.ResultsThemeaneosinophilcationicproteinvaluewassignificantly12decreased(32．1±11．8VS20．2±11．2,P<0．01)andFEV1wassignificantlyincreased(78．9±10．9VS103±13．7,P<0．05)after8weeks’treatmentwithmontelukast.ThemeanserumIL-2Rlev
7、elsweresignificantlyhigherinthebefore-treatmentgroupthanthatintheafter-treatmentgroup(1034．77±175．18,773±230．19,P<0．05)orincontrolsubjects(571．11±123．12;P<0．01).ThemeanserumTNF-αlevelwashigherinthebefore-treatmentgroupthanthatintheafter-treatmentgroupandcontro
8、lgroup(8．60±1．79,5．89±2．16,5．10±1．07;P<0．05).TheSpearmanregressionanalysisshowedtherewasnegativecorrelationbetweenTNF-αandsIL-2Rinpatientsbeforemontelukasttreatment(r=0．665;P<0．01)
