卡介菌多糖核酸治疗慢性荨麻疹患者嗜酸性粒细胞趋化因子、肿瘤坏死因子α和干扰素γ水平的检测

Determination of eotaxin, tumor necrosis factor-α and interferon-γ levels in plasma from patients with chronic urticaria treated with the combination of BCG-PSN and cetirizine

目的探讨卡介菌多糖核酸（BCG—PSN）联合西替利嗪治疗慢性荨麻疹患者，血浆嗜酸性粒细胞趋化因子（eotaxin）、肿瘤坏死因子（TNF）α和干扰素（IFN）γ水平的检测。方法用BCG—PSN联合西替利嗪治疗慢性荨麻疹患者，其中联合用药组60例、单独用药组63例，观察两种治疗方案的临床疗效；分别于治疗前、后采集患者和56例健康对照者外周静脉血；ELISA法检测患者治疗前、后和健康对照组血浆eotaxin、TNF—α和IFN-γ水平。结果BCG—PSN联合西替利嗪治疗总有效率显著高于单用西替利嗪治疗（88．3％比63．4％，P〈0．05）。治疗前两组患者血浆eotaxin、TNF-α和IFN-γ水平差异无统计学意义（均P〉0．05）。治疗前两组患者血浆eotaxin和TNF-α水平均高于健康对照组（均P〈0．05），血浆IFN-γ水平低于健康对照组（P〈0．05）；两种方案治疗后血浆eotaxin、TNF-α和IFN-γ水平与健康对照组比较，差异均无统计学意义（均P〉0．05）。与单用西替利嗪治疗比较，BCG—PSN联合西替利嗪治疗后血浆eotaxin水平下降程度（13．27±4．11比8．12±2．58，t=8．3654，P〈0．05）和TNF-α水平下降度（12．38±3．95比10．32±3．41，t=3．1005，P〈0．05）更为显著，且IFN-γ水平升高程度（17．06±5．24比12．54±4．07，t=5．3573，P〈0．05）更为显著。结论BCG—PSN联合西替利嗪治疗的临床效果优于单用西替利嗪治疗。

Objective To investigate the changes to eotaxin, tumor necrosis factor-α （TNF-α） and interferon-γ （IFN-γ） in plasma from patients with chronic urticaria treated with the combination of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin （BCG-PSN） and cetirizine. Methods Totally, 123 patients with chronic urticaria were enrolled into this study, and classified into two groups： the combination therapy group （n = 60） treated with intramuscular BCG-PSN 2 ml every other day and oral cetirizine 10 mg once daily, and the monotherapy group （n = 63） treated with oral cetirizine 10 mg once daily alone. The treatment lasted 54 days. Clinical efficacy was evaluated. Venous blood samples were collected from the patients before and after the treatment, as well as from 56 healthy controls. Enzyme-linked immunosorbent assay was performed to quantify the plasma levels of eotaxin, TNF-α and IFN-3,. Results At the end of the treatment, the total response rate was significantly higher in the combination therapy group than in the monotherapy group （ 88.3% vs. 63.4%, P 〈 0.05 ）. Before the treatment, no significant differences were observed in the plasma levels of eotaxin, TNF-α or IFN-γ between the two treatment groups, whereas the patients showed higher plasma levels of eotaxin and TNF-α but lower plasma level of IFN-γ compared with the healthy controls （all P 〈 0.5）. Both the combination therapy and monotherapy resulted in a statistical decrease in plasma eotaxin and TNF-α but an increase in plasma IFN-γ （all P 〉 0.05）, and the absolute values of changes in the three parameters were significantly higher in the combination therapy group than in the monotherapy group （eotaxin： （13.27 ＋ 4.11）μ.g/L vs. （8.12 ＋ 2.58）μg/L, t = 8.3654, P 〈 0.05; TNF-α （ 12.38 ＋ 3.95 ） ng/L vs. （ 10.32 ＋ 3.41 ） ng/L, t = 3.1005, P 〈 0.05; IFN-γ （ 17.06 ＋ 5.24） μg/L vs. （12.54 ＋ 4.07） μg/L, t = 5.3573, P 〈 0.05）. Further more, the differences between the patients and healthy controls in the three parameters disappeared at the end of the treatment （all P 〉 0.05）. Conclusion BCG-PSN combined with cetirizine seems superior to cetirizine alone for the treatment of chronic urticaria.