小剂量罗红霉素对支气管扩张症NF-κB通路及气道炎症的影响以及临床疗效研究

Effect of low dose roxithromycin on NF-κB pathway and airway inflammation in patients with bronchiectasis and its clinical efficacy

目的观察小剂量罗红霉素对支气管扩张症患者NF-κB通路及气道炎症的影响。方法 92例支气管扩张症患者分为对照组和小剂量罗红霉素治疗观察组,每组46例。p65、IL-6和TNF-α蛋白的表达检测使用ELISA法。结果治疗后观察组p65、IL-6和TNF-α蛋白表达显著减低(P<0.05),但对照组无显著性变化(P>0.05)。治疗后观察组对生活质量评分、呼吸困难评分和痰量的减低作用,以及对FEV1%和FEV1/FVC的升高作用显著优于对照组(P<0.05)。治疗期间观察组急性加重1.54±0.28次,显著低于对照组的2.12±0.46次(P<0.05)。观察组临床治疗有效率为84.8%(39/46),显著高于对照组的71.7%(33/46)(P<0.05)。观察组临床治疗不良反应率为13.0%(6/46),对照组临床治疗不良反应率为10.9%(5/46),两组之间无显著性差异(P>0.05)。结论小剂量罗红霉素可以抑制支气管扩张症患者NF-κB通路,减轻气道高炎症反应,改善患者临床症状,提高生活质量和肺功能,疗效显著,使用安全。

Objective To detect the effect of low dose roxithromycin on NF-κB pathway and airway inflam-mation in patients with bronchiectasis. Methods A total of 92 bronchiectasis patients were enrolled in this study, and they were randomly divided into the control group （n=46） and the low dose roxithromycin observation group （n=46）. The expression of p65, IL-6 and TNF-α were detected by ELISA analysis. Results After treatment, p65, IL-6 and TNF-αdecreased in the observation group （P〈0. 05） and didn’t change in the control group （P〉0. 05）. After treatment, life quality score, dyspnea score, and day and night sputum volume was lower in the observation group than in the control group （P〈0. 05）, and FEV1% and FEV1/FVC was higher in the observation group than in the control group （ P〈0. 05 ） . The acute exacerbation frequency was 1. 54 ± 0. 28 times in the observation group, which was significantly lower than that of 2. 12 ± 0. 46 times in the control group （P〈0. 05）. The rate of clinic effect was 84. 8% （39/46） in the observation group, which was higher than 71. 7% （33/46） in the control group （P〈0. 05）. The incidence of adverse reaction was 13. 0% （6/46） in the observation group and 10. 9% （5/46） in the control group. There was no significant difference between the two groups （P〉0. 05）. Conclusion Low dose rox-ithromycins can inhibit NF-κB pathway and airway local inflammatory response in patients with bronchiectasis, which can improve clinical symptoms, life quality, and lung function, with significantly clinical efficacy and safety.