布地奈德对支气管哮喘患者气道重塑及肺功能影响的疗效评价

Evaluation of Budesonide on airway remodeling and lung functionin in asthma

目的本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling, lung function and peripheral blood concentra- tions of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remode- ling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital, and given treatment of inhaled budesonide for 6 months, and to detect lung function, pheral blood TGF-β, concentration as well as measuring the bronchial wall thickness （T） and calculate the wall area （WA） , the outer diameter of the trachea and bronchial wall thickness ratio （ WT% ）, the cross-sectional area of the airway wall accounted for airway percentage （ WA% ） of the total cross-sectional area by high-resolution CT （HRCT） before and after treatment. Results After treatment with inhaled budes- onide in six months, the asthma WT% , WA% , lung function, and TGF-βconcentrations were significantly improved, the differ- ences compared with that before treatment were statistically significant （ P 〈 0. 05 ）. Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function, possibly related to down the expression TGF-β.