老年慢性阻塞性肺病患者经激素及β受体激动剂治疗对IL-8和IL-10表达的影响及其临床疗效

Clinical Effect of Hormone and β-Adrenoceptor Agonist on IL-8 and IL-10 Expression in Elderly Patients with Chronic Obstructive Pulmonary Disease

目的探讨老年慢性阻塞性肺疾病(COPD)患者经β-受体激动剂和激素治疗前后,IL-8和IL-10表达的变化及其临床疗效。方法选取COPD患者112例随机分为A组、B组、C组以及D组各28例。A组采用常规治疗方案进行治疗,B组在常规治疗方案的基础上,加用硫酸特布他林雾化液雾化吸入,C组在常规治疗方案的基础上,加用吸入用布地奈德混悬液雾化吸入,D组在常规治疗方案的基础上,联合使用硫酸特布他林雾化液和布地奈德混悬液雾化吸入。对比四组患者治疗前后诱导痰中IL-8和IL-10浓度以及肺功能指标的变化情况。结果治疗后,A组的IL-8浓度为(712.57±77.69)ng/L,B组为(735.17±99.53)ng/L,C组为(689.21±97.48)ng/L,D组为(599.37±131.25)ng/L,均显著低于治疗前(均P<0.05),而D组治疗后的IL-8浓度显著低于其余三组(P<0.05)。治疗后,A组的IL-10浓度为(31.96±15.85)ng/L,B组为(32.09±11.53)ng/L,C组为(36.39±17.26)ng/L,D组为(37.04±15.38)ng/L,C组和D组治疗后的IL-10浓度显著高于治疗前(均P<0.05),但是四组治疗后的IL-10浓度比较,差异没有统计学意义(P>0.05);治疗后,D组患者的FEV1%预测值为(37.94±11.63)、C组为(37.82±12.76),均显著高于A组(29.68±9.98)和B组(33.87±10.07)(均P<0.05),其余肺功能指标治疗前后的组间对比,差异没有统计学意义(均P>0.05)。四组患者经过治疗后,其FVC、FVC%预测值、FEV1以及FEV1%预测值均显著高于治疗前,而FEV1/FVC则显著低于治疗前(均P<0.05)。结论在COPD的炎症过程中,IL-8和IL-10发挥了重要的作用,激素的应用可升高IL-10而降低IL-8的浓度,且激素和β-受体激动剂的联合应用疗效更佳。

Objective To investigate intefleukin-8 （IL-8） and interleukin-10 （IL-10） expression changes in elderly patients with chronic obstructive pulmonary disease （COPD） before and after treatment of hormone andfl-adrenoceptor agonist and their clinical efficacy. Methods 112 patients with COPD were randomly divided into group A, group B, group C and group D, with 28 cases in each. Patients in group A were treated with conventional therapy, patients in group B were treated with Terbutaline Sulphate Solution for nebulization inhalation based on conventional therapym, patients in group C were treated with Budesonide Suspension for inhalation based on conventional therapy, and patients in group D were treated with Terbutaline Sulphate Solution and Budesonide Suspension based on the conventional therapy. The concentration of IL-8 and IL-10 in sputum and the pulmonary function indices of the four groups were compared before and after treatment. Results After treatment, the concentration of IL-8 in group A was （712.57± 77.69） ng/L. group B （735.17 ±99.53） ng/L, group C （689.21 ~ 97.48） ng/L, group D （599.37± 131.25） ng/L, which were significantly lower than those before treatment （P 〈0.05）. And the IL-8 concentration of group D after treatment was significantly lower than the other three groups （P 〈0.05）. Alter treatment, the concentration of IL-10 in group A was （31.96 ± 15.85） ng/L, group B （32.09± 11.53） ng/L, group C （36.39± 17.26） ng/L, group D （37.04 ±15.38） ng/L. The IL-10 concentration of group C and group D after treatment were significantly higher than those before treatment （P〈0.05）, but the difference between the four groups alter treatment was not statistically significant （P 〉0.05）. After treatment, the FEV1% predictive value of group D was （37.94 ±11.63）, group C （37.82 ± 12.76）, which were significantly higher than group A （29.68 ± 9.98） and group B （33.87± 10.07） （all P〈0.05）. The comparison of the remaining lung function indices among the four groups before or after treatment had no statistical significant difference （P〉0.05）. The FVC, FVC%, FEV1 and FEVI% forecast predicted values of the four groups after treat ment were significantly higher than those before treatment, and FEVI/FVC was significantly lower than that before treatment （P 〈0.05）.Conclusions In the inflammatory process ofCOPD, IL-8 and IL-10 play important roles. Hormone can increase the IL-10 concentration and reduce the IL-8 concentration. Hormone combined with β-adrenoceptor agonist has better clinical efficacy.