局部注射复方倍他米松对良性中央气道狭窄胶原蛋白沉积的影响

The effect of locally injected betamethasone on collagen deposition in benign central airway stenosis

目的了解黏膜下注射复方倍他米松对气道瘢痕组织增生的影响。方法采用前瞻性自身对照研究，检测良性气道狭窄经常规介入治疗（CI）及CI联合局部注射复方倍他米松（LBI）治疗前和7 d后局部组织中转化生长因子（TGF）－β1和胶原蛋白平均吸光度值的变化情况。结果2013年5月至2015年6月共6例患者完成试验。CI前后TGF－β1平均吸光度值分别为92±38和164±47（t＝－7.984，P＝0.000），LBI前后TGF－β1平均吸光度值分别为128±45和78±40（t＝10.055，P＝0.000）; CI前后胶原蛋白分别为91 932±59 520和150 252±76 673（t＝－8.105，P＝0.000）；联合LBI前后胶原蛋白分别为107 024±54 880和114 038±50 772（t＝－0.621，P＝0.54）。将联合LBI前后变化趋势与CI前后变化趋势对比，TGF－β1（F＝712.139，P＝0.000）和胶原蛋白（F＝261.256，P＝0.000）差异均有统计学意义。结论 CI治疗可以刺激局部TGF－β1表达增加及胶原的合成及沉积，而LBI有助于减少TGF－β1的生成，减轻介入治疗后胶原蛋白的合成及沉积。

ObjectiveTo assess the effects of locally injected betamethasone on cicatricial tissue hyperplasia in patients with benign central airway stenosis.MethodsA prospective study was conducted with 2 treatment modalities： conventional interventional（CI）therapy, and CI combined with local betamethasone injection（LBI）. The average optical density value of TGF-β1 and collagen density in the local airway tissues were compared before therapy and 7 d after the CI treatment and the LBI treatment, respectively.ResultsSix patients were recruited in this study from May 2013 to June 2015.The results showed significant statistical differences by paired t-test in TGF-β1： 92±38 vs 164±47（t=-7.984, P=0.000）before and after the CI treatment, respectively; 128±45 vs 78±40 （t=10.055, P=0.000）before and after the LBI treatment, respectively. The collagen density was 91 932±59 520 vs 150 252±76 673（t=-8.105, P=0.000） before and after the CI treatment, respectively; 107 024±54 880 vs 114 038±50 772（t=-0.621, P=0.54） before and after the LBI treatment, respectively.Trend comparisons made before and after the treatments showed significant statistical differences in TGF-β1（F=712.139, P=0.000） and in the collagen density （F=261.256, P=0.000）between the CI treatment and the LBI treatment groups.ConclusionsThe CI treatment was shown to stimulate the production of TGF-β1 and the deposition of collagen, while the LBI treatment was shown to reduce the production of TGF-β1 and alleviate the deposition of collagen from the stimulation of the CI treatment.