联合吸入治疗对AECOPD患者外周T淋巴细胞、IL-2、CRP表达的调节以及肺功能的影响

Effects of lnhaling GCS and LABA in treating AECOPD through determining the T cell subsets,IL-2,C-reactive protein,lung function

目的探讨联合吸入治疗对慢性阻塞性肺病急性加重期患者外周T淋巴细胞,IL-2、CRP表达的调节以及肺功能的影响。方法选取40例慢性阻塞性肺病急性加重期患者(肺功能Ⅲ级和Ⅳ级)随机分为两组,对照组和治疗组各20例。健康组20例。对照组采用抗生素、多索茶碱、止咳化痰常规治疗;治疗组在常规治疗基础上吸入沙美特罗/氟替卡松(舒利迭50μg/500μg),疗程均为2周。测定治疗前患者T细胞亚群、IL-2、CRP水平、肺功能,并与健康组进行比较,同时对比治疗组和对照组患者治疗前后各项指标改善有无统计学差异。结果慢性阻塞性肺病急性加重期患者外周血IL-2水平、CD3、CD4、CD4/CD8水平、肺功能明显低于健康组(P<0.05),血清CRP水平较健康组明显升高(P<0.05),经过治疗后各项指标明显改善,治疗组较对照组改善更明显(P<0.05),但与健康对照组仍有差距。结论无论在慢性阻塞性肺病的发作期还是缓解期,体内炎症反应依然存在,气道高反应性也仍然存在。联合吸入可以从各个环节治疗慢性阻塞性肺病急性加重期,在控制、预防慢性阻塞性肺病急性发作及缓解期慢性阻塞性肺病患者后续治疗中具有广泛的临床应用前景,应积极推荐使用。

[Objective] To investigate the effects of inhaling GCS and LABA in treating AECOPD through determining the T cell subsets, IL-2, C-reactive protein, lung function. [Methods] Forty samples who have been definitely diagnosed as AECOPD （stage Ⅲ or Ⅳ） are randomly divided into two group, the control group and the treat- ment group, 20 samples for each other. The control group uses conventional therapy contain antibiotics, doxofyiline, apophlegmatisant and antitussive, and the treatment group gets an additional treatment by applying Salmeterol/tlutieasone propionate（Seretide 50 μg/500μg）, twice a day. The course of the treatments are two weeks. We determining the T cell subsets, IL-2, C-reactive protein, lung function before and after the treatments on both two groups to compare whether the indexes have differences in statistics. [Results] The level of IL-2, CD3, CD4, CD4/CD8, lung function in the peripheral blood of patients with AECOPD was lower than the level of the health group, the level of C-reactive protein raised, and the target improved significantly after treatment in both two groups （P 〈0.05）, which has statistical difference. But it still has different contrasted with the healthy group. [Conclusions] AECOPD, even the patients with AECOPD have relieved, there is also inflammatory reaction and airway hyper-reaetivity, the patients should continue to receive treatment. Inhaling GCS and LABA can cure AECOPD in many ways, such as controlling and preventing the exacerbation of COPD, this teatment has wide clinical perspective.