雾化吸入糖皮质激素治疗慢性阻塞性肺疾病急性加重期患者的疗效被引量：4

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摘要目的探讨雾化吸入糖皮质激素治疗慢性阻塞性肺疾病急性加重期患者的疗效,并进一步探讨慢性阻塞性肺疾病的发病机制。方法分别测定对照组、非吸入组和吸入组治疗前后的肺功能指标、血清及诱导痰中IL-8和TNF-α的水平。采用SPSS13.0软件包对数据进行统计学分析。结果治疗后肺功能指标与治疗前比较均明显升高,吸入组升高更明显,但仍低于对照组(P<0.05);治疗前非吸入组和吸入组患者血清中IL-8、TNF-α水平明显高于对照组,且与FEV1和FEV1占预计值百分比呈负相关(P<0.05);治疗后血清和痰液中IL-8、TNF-α水平较治疗前明显下降,且吸入组与非吸入组比较痰液中IL-8和TNF-α下降更为显著(P<0.05),但治疗后两组患者血清中IL-8、TNF-α水平无统计学差异(P>0.05)。结论糖皮质激素吸入疗法可以有效地改善肺功能,降低诱导痰中炎症介质IL-8、TNF-α的水平,进而减轻全身、尤其气道和肺组织的炎症反应。

作者刘颖于振香赵自然王浩东

机构地区吉林大学第一医院

出处《中国老年学杂志》 CAS CSCD 北大核心 2011年第21期4097-4099,共3页 Chinese Journal of Gerontology

基金吉林省科技厅资助课题(200705152)

关键词慢性阻塞性肺疾病肺功能 IL-8 TNF-Α

分类号 R563.9 [医药卫生—呼吸系统]

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参考文献10

1慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华内科杂志,2007,46(3):254-261. 被引量：1790
2GOLD Committees. Global strategy for the diagnosis, management, and prevention of ehronie obstructive puhnonary disease (2006). www. gold- eopd. org [J].Date last aeeessed: January,2007.
3Camussi G,Albano E ,Tetta C ,et al. The molecular action of tumor necro- sis factor-a[J].Eur J Biochem, 1991 ;202:3-14.
4Strieter RM, Kunkell SL, Showell HJ,et al. Endothelial cell gene expres- sion of a neutrophil chemotactic factor by TNF-alpha,LPS,and IL-1 beta [J].Science, 1989 ;243 (4897) : 1467-9.
5Wilkinson TM,Patel IS, Wilks M, et al. Airway bacterial load and FEV1 decline in patients with chronic obstructive pulmonary disease [J].Am J Respir Crit Care Med ,2003 ; 167 ( 8 ) : 1090-5.
6Pei XH, Nakanishi Y, Inoue H, et al. Polycyclic aromatic hydrocarbons in- duce IL-8 expression through nuclear factor kappa B activation in A549 cell line[J].Cytokine ,2002 ;19(5 ) :236-41.
7Brasier AR, Jamaluddin M, Casola A,et al. A promoter recruitment mech- anism for tumor necrosis factor alpha induced interleukin-8 transcription in type U pulmonary epithelial cells. Dependence on nuclear abundance of Rel A, NF-kappa B1, and c-Rel transcription factors[J].J Biol Chem, 1998 ;273(6) :3551-61.
8Osawa Y, Nagaki M, Banno Y, et al. Tumor necrosis factor alpha-induced interleukin-8 production via NF-kappaB and phosphatidylinositol 3-ki- nase/Akt pathways inhibits cell apoptosis in human hepatocytes[J]. In- fect Immun,2002 ;70( 11 ) :6294-301.
9Amstrong WS, Katz JT, Kazanjian PH. Human immunodeficiency virus-as- sociated fever of unknown origin: a study of 70 patients in the United States and review[J].Clin Infect Dis, 1999 ;28:341-5.
10Beutler B, Krochin N, Milsark IW, et al. Control of cachectin ( tumor necrosis factor) synthesis: mechanisms of endotoxin resistance [J].Science, 1986 ;232(4753 ) :977-80.

二级参考文献7

1有创-无创序贯机械通气多中心研究协作组.以肺部感染控制窗为切换点行有创与无创序贯机械通气治疗慢性阻塞性肺疾病所致严重呼吸衰竭的随机对照研究[J].中华结核和呼吸杂志,2006,29(1):14-18. 被引量：279
2冉丕鑫王辰姚婉贞等.我国部分地区慢性阻塞性肺疾病流行病学研究[J].中华结核和呼吸杂志,2007,.
3GOLD Executive Committee[DB/OL]. Guidelines: Global Strategy for Diagnosis, Management, and Prevention of COPD,November 2006 [ 2006-11-18 ]. http://www.goldcopd.com/Guidelineitem. asp? 11 =2&12 = 1&intId =989.
4Celli BR, MacNee W, Committee members. Standard for the diagnosis and treatment of patients with COPD : a summary of the ATS/ERS position paper. Eur Respir J, 2004,23:932-946.
5Celli BR, Cote CG, Matin JM, et al. The body mass index,airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004,350 : 1005-1012.
6王辰,杜敏捷,曹大德,翁心植,吴小青,常青,王瑜.慢性肺原性心脏病急性发作期肺细小动脉血栓形成的病理观察[J].中华医学杂志,1997,77(2):123-125. 被引量：498
7沈宁,姚婉贞,朱红,赵鸣武.慢性阻塞性肺疾病患者肺组织胆碱能M受体及其亚型的变化[J].中华结核和呼吸杂志,2001,24(4):212-214. 被引量：26