盐酸非索非那定联合卡介菌多糖核酸对CIU患者血清总IgE及Th1/Th2的影响

Effect of Fexofenadine Hydrochloride Combined with BCG-PSN on Total Serum IgE and Th1 / Th2 Cytokine in Patients with Chronic Idopathic Urticaria

目的研究卡介菌多糖核酸对慢性特发性荨麻疹(CIU)患者血清总IgE及Th1/Th2细胞因子的调节作用,以探讨卡介菌多糖核酸治疗CIU的作用机制。方法 118例CIU患者随机分为治疗组(62例,口服盐酸非索非那定60mg,2次/d,并予卡介菌多糖核酸注射液0.7mg肌肉注射,3次/周)与对照组(56例,口服盐酸非索非那定60 mg,2次/d),并另选38例健康人为健康对照组。采用双抗体夹心ELISA法检测患者外周血总IgE水平,同时用IMMAGE双光径免疫浊度分析仪检测患者外周血IgG,C3和C4水平。用ELISA法同批检测血清IL-2,IL4和IFN-γ水平。结果 CIU组血清总IgE和IL-4水平明显高于健康对照组,IL-2和IFN-γ水平均低于健康对照组,治疗14d及28d时有效率均高于对照组;而且治疗28d时,CIU治疗组内的有效率也高于14d时,CIU治疗组和CIU对照组的血清总IgE和IL-4水均低于其治疗前,以上差异组均有统计学意义(P均<0.05)。CIU组血清C3和C4水平低于健康对照组,IgG水平高于健康对照组,而且治疗28d时,对照组内的有效率高于治疗14d时,治疗组血清总IgE和IL-4水平均低于对照组,CIU治疗组和对照组血清IL-2和IFN-γ水平均高于治疗前的健康照组,但以上差异均无统计学意义(P均>0.05)。结论卡介菌多糖核酸联合盐酸非索非那定治疗CIU的临床疗效优于单用盐酸非索非那定,有利于降低CIU患者血清总IgE与纠正Th1/Th2细胞因子失衡状态,且不良反应少。

Objective To investigate regulatory effect of fexofenadine hydrochloride combined with BCG-Polysaccharides nucleic acid （BCG-PSN） on total serum IgE and Th1/Th2 cytokine in patients with chronic idopathic urticaria （ CIU）, and to further investigate the mechanism whereby BCG - PSN treats CIU. Methods A total of 118 patients with CIU and 38 normal controls were enrolled in this study. 62 patients with CIU were treated with oral fexofenading 60mg twice daily, and given BCG polysaccharide nucleic acid by injection 0.7mg, 3 times per week; 56 patients treated with oral fexofenading alone served as controls. The total serum IgE, IL-2, IL-4 and IFN-γ were measured by sandwich ELISA, and the expression levels of C3, C4 and IgG were measured by Immune Turbidimetry. Results The expression levels of total serum IgE and IL4 were higher in CIU than normal （P 〈0. 001 ） while expression levels of IL-2 and IFN-γ were lower in CIU than normal（P 〈0.05）. Although the expression levels of C3 and C4 were lower, and IgG were higher in CIU than normal, the differences were not significant （P 〉 0.05 ）. After lgd and 28d treatment the treatment group displayed higher effective rates than control group（P 〈 0.05）. The effective rates were higher at 28d than 14d in both the treatment and con- trol groups. After 28d treatment the levels of total serum IgE and IL-4 were similar between treatment and control groups, but significant lower than before treatment in both groups （P 〈 0. 001 ）, In contrast, After 28d treatment the levels of IL-2 and IFN-γ in both groups were higher than before treatment （P 〉 0.05 ）. In addition, the expression the levels of IL-2 and IFN-γ in treatment group were higher than that in normal controls （P 〉 0.05）. Conclusion Combination fexofenadine hydrochloride and BCG-PSN is more effective than fexofenadine hydrochloride alone in treating CIU, reducing serum IgE levels and correcting the imbalance of Th1/Th2 cytokines with few side effects.