布地奈德/福莫特罗吸入对哮喘患者血清基质金属蛋白酶-2、9水平的影响及疗效观察

Influence and curative effect of inhalation of formoterol/budesonide on matrix metalloproteinase of plasma-2 and 9 for asthmatic patients

目的 探讨布地奈德/福莫特罗吸入对哮喘患者血清基质金属蛋白酶（MMP）-2、9水平的影响及疗效.方法 选择68例急性发作期的哮喘患者,采用随机数字表将纳入患者分为观察组和对照组.两组均予以抗感染、解痉平喘、止咳祛痰等常规治疗.观察组患者加用布地奈德/福莫特罗吸入,4.5μg/160 μg/次,2次/d,连用2周.对照组除不使用布地奈德/福莫特罗外,余同对照组.观察两组患者治疗前和治疗2周后血清MMP-2、9水平的变化,并进行疗效及安全性观察.结果 治疗2周后,两组血清MMP-2和MMP-9较治疗前均有明显下降（=2.87、2.97、2.21、2.31,P＜0.01或P＜0.05）,且观察组比对照组下降更明显（t=2.45、2.37,均P＜0.05）;同时观察组的临床总有效率（94.12％）明显高于对照组（70.59％）（x2=6.48,P＜0.05）;对照组和观察组患者治疗期间分别出现不良反应3例和5例,症状均较轻,未发生严重的不良反应.两组患者的不良反应发生率差异无统计学意义（x2=0.14,P＞0.05）.结论 布地奈德/福莫特罗吸入治疗哮喘疗效和安全性较好,作用机制与下调MMP-2、9水平,纠正细胞外基质的降解和修复平衡失调,抑制气道重构密切有关.

Objective To discuss the influence and curative effect observation of inhalation of formoterol/budesonide on matrix metalloproteinase of plasma（MMP）-2 and 9 for asthmatic patients （AAPs）.Methods According to the digital table,68 cases of AAPs in acute stage of attack were randomly divided into observation group and control group.The patients in two groups were given routine medical treatments like anti-infection,antispasmodic and relieving asthma,relieving coμgh and reducing sputum and etc.In addition,the patients in observation group were given the inhalation of formoterol/budesonide with 4.5μg/160μg,two times daily for 2 weeks.Except for formoterol/budesonide,the medical treatments given to patients in control group were the same with those in observation group.The changes of MMP-2 and 9 levels in blood serum before and after 2 weeks＆#39; medical treatment were observed and compared,and proceed with the curative and safety observation.Results After 2 weeks＆#39; medical treatment,the MMP-2 and 9 in blood serum both were declined sharply（t =2.87,2.97,2.21,2.31,P 〈 0.01 or P 〈 0.05）,and the compared with control group,the decrease value（t =2.45,2.37,all P 〈 0.05） was obviously higher.Meanwhile,the total clinical effective rate in observation group （94.12%） was obviously higher than that in control group （70.59%）（x2 =6.48,P 〈 0.05） ; The numbers of untoward effect occurrence in the medical treatment period were 3 cases in control group and 5 cases in observation group,which both had light symptom and did not appeared serious untoward effects.The comparison result of untoward effect between two groups had no obvious statistical difference（x2 =0.14,P 〉 0.05）.Conclusion formoterol/budesonide has reliable medical treatment effect and high security to asthmatic,whose mechanism of action has effect on MMP-2 and 9 level adjustment,correction of degradation of extracellular matrix and dysequilibrium,and chronic airway inhibition and remodeling.