小剂量茶碱短期治疗对稳定期COPD患者炎性因子及细胞免疫功能的影响

Influence of short-term treatment of low-dose theophylline on the inflammatory factors and cellular immune function in patients with stable chronic obstructive pulmonary disease

目的观察小剂量茶碱短期治疗对稳定期慢性阻塞性肺疾病(COPD)患者炎性因子、细胞免疫功能的影响。方法选取2016年1~10月期间就诊于武汉市普仁医院呼吸科的79例稳定期COPD患者为观察对象,按用药方案差异分为对照组(38例)和观察组(41例)。两组患者均接受常规对症治疗,观察组给予短期(3周)小剂量(200 mg/d)茶碱治疗。比较两组患者治疗前后肺功能、痰液炎性细胞因子、血清炎性细胞因子及免疫功能检测指标差异。结果治疗后观察组与对照组比较,1 s用力呼气量(FEV1)[(58.34±6.70)%vs(51.33±5.68)%]、1s用力呼气量占预计值百分比(FEV1%)[(76.09±5.22)%vs(70.33±4.91)%]、1s用力呼气量占用力肺活量的百分比FEV/FVC%[(66.17±8.14)%vs(60.49±8.17)%]、成熟T淋巴细胞表面标志CD3^+[(193.08±26.84)ng/L vs(54.38±4.81)ng/L]、辅助性T淋巴细胞CD4^+[(234.27±30.09)ng/L vs(36.65±3.94)ng/L]、抑制/杀伤性T淋巴细胞CD4^+/CD8^+[(168.31±22.84)ng/L vs(1.14±0.26)ng/L],观察组均高于对照组(P<0.05);痰液白介素-6(IL-6)[(151.66±23.51)ng/L vs(193.08±26.84)ng/L)]、白介素-8(IL-8)[(301.63±34.26)ng/L vs(433.77±35.53)ng/L]、肿瘤坏死因子-α(TNF-α)[(128.57±20.87)μg/L vs(168.31±22.84)μg/L]和血清IL-6[(157.48±22.47)ng/Lvs(188.11±27.16)ng/L]、IL-8[(314.43±24.35)ng/L vs(387.64±27.21)ng/L]、TNF-α[(139.15±26.51)μg/L vs(171.19±29.82)μg/L],观察组均低于对照组,差异均有统计学意义(P<0.05)。结论小剂量茶碱短期治疗可有效提升稳定期COPD患者肺功能、炎性因子和细胞免疫功能水平,可作为稳定期COPD患者的辅助治疗方法。

Objective To observe the influence of short-term treatment of low-dose theophylline on the inflammatory factors and cellular immune function in patients with stable chronic obstructive pulmonary disease（COPD）, and to provide reference for the clinical treatment of COPD. Methods From January 2016 to October 2016, 79 patients with stable COPD, who admitted to Department of Respiratory of Wuhan Puren Hospital, were enrolled in this study.Those patients were divided into the control group（38 cases） and observation group（41 cases） according to the random number method. Both groups received routine western medicine symptomatic treatment, but the observation group received short-term（3 weeks） treatment of small-dose theophylline（200 mg/d）. The changes of pulmonary function, inflammatory cytokines, serum inflammatory cytokines and immune function were compared between the two groups before and after treatment. Results After treatment, the forced expiratory volume in 1 second（FEV1）, forced expiratory volume in 1 second percentage（FEV1%）, ratio of forced expiratory volume in one second to forced vital capacity（FEV/FVC%）, mature T-lymphocyte surface signs of CD3~＋, helper T lymphocytes of CD4~＋, and suppress/kill T lymphocytes of CD4~＋/CD8~＋in the observation group were（58.34 ± 6.70）%,（76.09 ± 5.22）%,（66.17 ± 8.14）%,（193.08 ± 26.84） ng/L,（234.27 ± 30.09） ng/L,（168.31 ± 22.84） ng/L, respectively, which were significantly higher than corresponding（51.33 ±5.68）%,（70.33±4.91）%）,（60.49±8.17）%,（54.38±4.81） ng/L,（36.65±3.94） ng/L,（1.14±0.26） ng/L in the control group;the interleukin-6（IL-6）, interleukin-8（IL-8）, and tumor necrosis factor-α（TNF-α） in sputum and serum were respectively（151.66±23.51） ng/L,（301.63±34.26） ng/L,（128.57±20.87） μg/L and（157.48±22.47） ng/L,（314.43±24.35） ng/L,（139.15±26.51） ng/L in the observation group, which were significantly lower than corresponding（193.08±26.84） ng/L,（433.77±35.53） ng/L,（168.31±22.84） μg/L and（188.11±27.16） ng/L,（387.64±27.21） ng/L,（171.19±29.82） μg/L in the control group（P0.05）. Conclusion The short-term treatment of low-dose theophylline can effectively improve the lung function, inflammatory factors and cellular immune function levels in patients with stable COPD, so it can be used as an effective adjuvant therapy for patients with stable COPD.