胸腺肽α_1对哮喘患者Th_1/Th_2调控的临床研究

Clinical study of thymosin α_1 on regulating Th_1/Th_2 of asthma patients

目的探讨胸腺肽α1对哮喘患者Th1/Th2调控的影响。方法采用临床随机对照研究的方法将50例轻、中度哮喘患者随机分成两组:基础治疗组(A组)25例,采用吸入糖皮质激素加β2激动剂治疗;实验组(B组)25例,在A组治疗方法基础上,加用胸腺肽α1(基泰)1.6mg皮下注射,一周2次,疗程12周。治疗前后分别测量血清中白细胞介素4(IL-4)、干扰素γ(IFN-γ)、白细胞介素12(IL-12)、白细胞介素13(IL-13)指标含量,并观察肺功能FEV1值及免疫球蛋白E(IgE)变化。另设健康对照组(C组)20例。结果A、B两组患者肺功能FEV1值治疗后较基线值分别提高0.27L和0.33L,白天哮喘症状评分分别减少0.78和0.74分,夜间哮喘症状评分分别减少1.02和1.13分,沙丁胺醇使用量分别减少1.84和1.72喷/日,两组之间比较均无显著性差异(P均>0.05)。A、B两组治疗前IL-4、IL-13、IgE水平均较健康对照组明显升高(P均<0.01),治疗后检测上述指标有明显下降(P<0.01),而IFN-γ、IL-12、IFN-γ/IL-4及IL-12/IL-13比值则与之相反。A、B两组之间对比,实验组治疗后IL-12水平及IL-12/IL-13比值高于基础治疗组(P均<0.05)。两组的不良反应轻微,两组之间无显著差异(P>0.05)。结论胸腺肽α1可以提高哮喘患者IL-12水平和IL-12/IL-13比值,在调节哮喘患者的Th1/Th2平衡方面有一定增强作用,在哮喘缓解期维持治疗和调节免疫上有应用价值。

Objective To explore the effect of thymosin α1 on regulating Th1/Th2 of asthma patients. Methods The clinic random control study began with 50 light or midrange patients of asthma,who were randomly divided into two groups （ each group with 25 examples）. The foundation cure group （group A） was treated by combined glucocorticoid inhal with excitomotor. The experiment group （group B） , in addition to the group A method, also used thymosin α1 1.6 mg hypodermic injection （ih） 2 times a week （biw） for 12 weeks. The levels of IL-4, IFN-γ, IL-12, IL-13, and observed FEV1 of the lung function and the IgE varieties were examined before and after the treatment. Another group of 20 healthy cases was controls （ group C）. Results The FEV1 of lung function of patients from group A and B raised 0. 27 L and 0. 33 L respectively compared with the base line, the asthma symptom score reduced 0. 78 and 0. 74 respectively on the day, and reduced 1.02 and 1.13 respectively in the night,Salbutamol dosage reduced respectively 1.84 and 1.72 spray per day,but no significant difference showed between two groups （ P 〉 0. 05）. The levels of ex-IL-4, IL-13, IgE of group A, B were higher than group C before treatment （P 〈0. 01 ）, but descended obviously after the treatment （P 〈0. 01 ）. Then, the levels of IFN-γ,IL-12, IFN-γ/IL-4 and IL-12/IL-13 were contrary to it. Compared group B to A, the level of IL-12 and IL-12/IL-13 of group B were higher than group A after the treatment （ P 〈 0. 05 ）. Both adverse effects were slight, and no significant deviation was between them （ P 〉 0.05 ）. Conclusion The thymosin α1 can raise the level of IL-12 and IL-12/IL-13 of asthma sufferers. There is certain function on regulating the balance of sufferer＇s Th1/Th2, and apply value on maintenane therapy of paracmasis of asthma and regulating the immunity.