小剂量罗红霉素对吸烟哮喘患者气道炎症的影响

Influence of treating with roxithromycin on airway inflammation in patients with asthma who smoke

目的观察小剂量罗红霉素对轻度至中度支气管哮喘非急性发作期的吸烟患者气道炎症及疗效的影响。方法 46例轻至中度支气管哮喘的吸烟患者随机分为对照组(A组)及罗红霉素治疗组(B组)。A组吸入沙美特罗替卡松粉吸入剂(50/250μg),1吸/次,2次/天;B组口服罗红霉素分散片(0.15g/d)并吸入沙美特罗替卡松粉吸入剂(50/250μg),1吸/次,2次/天,共4周。治疗前后进行肺功能、诱导痰细胞分数计数及痰细胞中白介素-8(IL-8)的测定。结果患者气道内中性粒细胞、嗜酸性粒细胞及IL-8表达与第一秒用力呼气流量呈负相关(P<0.01),经4周治疗后B组患者气道内嗜酸性粒细胞、中性粒细胞及IL-8比A组显著减少(P<0.05),同时B组患者PEF及FEV1%均比A组明显提高(P<0.01)。结论口服小剂量罗红霉素联合吸入沙美特罗/替卡松比单纯吸入沙美特罗/替卡松减少支气管哮喘患者气道内嗜酸性粒细胞、中性粒细胞及IL-8,且比单纯吸入沙美特罗/替卡松治疗显著改善PEF及FEV1%。

Objective To investigate the influence and effect of treating with low dose roxithromycin on airway inflammation in asthma who have been smoking patients. Methods Forty-six patients with mild to moderate asthma who had been smoking were assigned to group A and group B randomly. The patients in group A received inhaling salmeterol/fluticasone（50/250μg）,one puff bid, 2 times/day. The patients in group B treated with oral roxithromycin dispersible tablet 0.15 g/d combining with inhaling salme- terol/fluticasone（50/250 μg）,one puff bid,2 times/day. The patients of two groups had been treated for 4 weeks. The lung func- tion,cells and interleukin-8（IL-8） in induced sputum of patients in the two groups were measured before and after treatment. Results There was negative correlation between the FEV1% and the number of eosinophile granulocyte,neutrophii and the concentration of IL-8 in induced sputum of the patients（P〈0.01）. The number of neutrophil,eosinophile granulocyte and the level of IL-8 of the patients in group B decreased more than those in the group A after 4 weeks of treatment（P〈0. 05）. Furthermore the PEF and FEV1% of the patients in group B were ameliorated significantly than those in group A（P〈0.01）. Conclusion The treatment of roxithromycin combining with salmeterol/fluticasone on patients with asthma who smoke can not only reduce the number of eosino- phile granulocyte,neutrophil and the level of IL-8 in induced sputum significantly, but also ameliorate the PEF and FEV1% of them significantly.