痰热清对AECOPD患者外周血单个核细胞TLRs/NF-κB信号通路相关细胞因子及气道重塑的影响

Effects of Tanreqing on TLRs/NF-κB Signaling Pathway-related Cytokines and Airway Remodeling of Peripheral Blood Mononuclear Cells in Patients with AECOPD

目的:探讨痰热清对慢性阻塞性肺疾病急性加重期(AECOPD)患者外周血单个核细胞蛋白质家族(TLRs)/核因子κB(NF-κB)信号通路相关细胞因子及气道重塑的影响。方法:选择2018年4月—2021年7月麻城市人民医院收治的132例AECOPD患者,采用信封法随机分为观察组、对照组,各66例。对照组采用常规治疗,观察组给予常规治疗+痰热清注射液治疗,分析对患者TLRs/NF-κB信号通路相关因子、气道重塑、肺功能、炎症因子、血气分析指标的影响。结果:治疗10 d后,两组Toll样受体2(TLR2)、Toll样受体4(TLR4)、NF-κB的mRNA水平均较治疗前降低,且观察组上述指标低于对照组,差异有统计学意义(P<0.05);治疗10 d后,两组肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、C反应蛋白(CRP)均较治疗前降低,且观察组以上指标显著低于对照组,差异有统计学意义(P<0.05);治疗10 d后,两组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气流量峰值(PEF)均较治疗前升高,且观察组上述指标均高于对照组,差异有统计学意义(P<0.05);治疗10 d后,两组气道壁厚度与气道管腔外径比值(T/D)、气道壁面积(WA)均较治疗前降低,气道腔面积(AI)升高,且观察组T/D、WA低于对照组,AI高于对照组,差异有统计学意义(P<0.05);治疗10 d后,两组动脉血氧分压(PaO_(2))较治疗前升高,动脉血二氧化碳分压(PaCO_(2))较治疗前降低,且观察组PaO_(2)高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。结论:AECOPD在应用痰热清注射液治疗后,可有效改善血气分析指标、肺功能指标,降低机体炎症因子及TLRs/NF-κB mRNA水平,进而改善气道重塑指标。

Objective:To explore the effect of Tanreqing on peripheral blood mononuclear cell Toll-like receptors(TLRs)/nuclear factor-κB(NF-κB)signaling pathway related cytokines and airway remodeling in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:A total of 132 patients with AECOPD who admitted to Macheng People's Hospital from April 2018 to July 2021 were randomly divided into observation group and control group using the envelope method,66 cases in each group.The control group was treated with conventional therapy,while the observation group was treated with conventional therapy+Tanreqing Injection,the impact on TLRs/NF-κB signal pathway related cytokines,airway remodeling,lung function,inflammatory factors,and blood gas analysis indicators in patients were analyzed.Result:After 10 d of treatment,the levels of Toll-like receptors-2(TLR2),Toll-like receptors-4(TLR4)and NF-κB mRNA in both groups were lower than those before treatment,and the above indicators in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After 10 d of treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and C-reactive protein(CRP)in both groups were lower than those before treatment,and the above indicators in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).After 10 d of treatment,the forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),and peak expiratory flow(PEF)in the two groups were higher than those before treatment,and the above indicators in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).After 10 d of treatment,the ratio of airway wall thickness to airway lumen outer diameter(T/D)and airway wall area(WA)in both groups were lower than those before treatment,while the airway wall area(AI)was higher than that before treatment,and the T/D and WA in the observation group were lower than those in the control group,while AI was higher than those in the control group,the differences were statistically significant(P<0.05).After 10 d of treatment,the arterial partial pressure of oxygen(PaO2)in the two groups was higher than that before treatment,while the arterial partial pressure of carbon dioxide(PaCO2)was lower than that before treatment,and PaO2 in the observation group was higher than that in the control group,the PaCO2 was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:After treatment with Tanreqing Injection,AECOPD patients can effectively improve blood gas analysis indicators and lung function indicators,reduce the levels of inflammatory factors and TLRs/NF-κB mRNA in body,and thereby improve airway remodeling indicators.