多索茶碱联合吸入剂治疗支气管哮喘急性发作的临床研究

Clinical study on doxofylline combined with inhalant treatment of acute attack of bronchial asthma

目的:研究多索茶碱联合吸入剂治疗支气管哮喘急性发作对炎症反应及免疫应答的影响。方法:选择在本院就诊的支气管哮喘急性发作患者作为研究对象,随机分为接受多索茶碱联合吸入剂治疗的观察组、接受常规吸入剂治疗的对照组。治疗前及治疗后3天时,测定血清中炎症介质、蛋白酶分子的含量以及外周血中免疫细胞的含量。结果:治疗后3天时,两组血清中Eotaxin、YKL40、LTB4、TGF-β1、POSTN、ADAM8、ADAM33、MMP9的含量以及外周血中Th2、Th9、Th17的含量均低于治疗前,血清中TIMP1的含量以及外周血中Th1、Treg的含量高于治疗前(P<0.05),且观察组血清中Eotaxin、YKL40、LTB4、TGF-β1、POSTN、ADAM8、ADAM33、MMP9的含量以及外周血中Th2、Th9、Th17的含量均低于对照组,血清中TIMP1的含量以及外周血中Th1、Treg的含量高于对照组(P<0.05)。结论:多索茶碱联合吸入剂治疗支气管哮喘急性发作能够更为有效地抑制炎症反应的激活、改善Th细胞介导的免疫应答。

Objective：To study the effect of doxofylline combined with inhalant on inflammation and immune response in acute attack of bronchial asthma.Methods：Patients with acute attack of bronchial asthma who were treated in Ganquan People’s Hospital in Yan’an Shaanxi Province between May 2015 and October 2017 were chosen as the research subjects and randomly divided into the observation group who received doxofylline combined with inhalant treatment and the control group who received conventional inhalant treatment.The contents of inflammatory mediators and protease molecules in serum as well as the contents of immune cells in peripheral blood were measured before treatment and 3 days after treatment.Results：3 days after treatment,Eotaxin,YKL40,LTB4,TGF-β1,POSTN,ADAM8,ADAM33 and MMP9 contents in serum as well as Th2,Th9 and Th17 contents in peripheral blood of both groups of patients were lower than those before treatment whereas TIMP1 contents in serum as well as Th1 and Treg contents in peripheral blood were higher than those before treatment（P〈0.05）,and Eotaxin,YKL40,LTB4,TGF-β1,POSTN,ADAM8,ADAM33 and MMP9 contents in serum as well as Th2,Th9 and Th17 contents in peripheral blood of observation group of patients were lower than those of control group whereas TIMP1 content in serum as well as Th1 and Treg contents in peripheral blood was higher than those of control group（P〈0.05）.Conclusion：Doxofylline combined with inhalant treatment of acute attack of bronchial asthma can more effectively inhibit the activation of inflammatory response and improve the immune response mediated by Th cells.