布地奈德/福莫特罗粉吸入治疗对支气管哮喘患者IL-33、IL-17水平及肺功能的影响

Influences of budesonide/formoterol powder inhalation on IL-33 and IL-17 levels in patients with bronchial asthma and pulmonary function

目的探讨支气管哮喘吸入布地奈德/福莫特罗干粉治疗对患者白细胞介素-17(IL-17)、白细胞介素-33(IL-33)水平及肺功能的影响。方法选取30例确诊为支气管哮喘的患者,分组依据随机数字表法进行,分为观察组和对照组,每组15例,均给予止咳、平喘、祛痰、维持水电解质平衡等基础治疗,同时观察组吸入布地奈德/福莫特罗干粉剂治疗,对照组雾化吸入布地奈德混悬液治疗,治疗前后检测两组患者的IL-33、IL-17等炎症因子水平及最大肺活量(FVC)、第1秒用力呼吸容积(FEV1)等肺功能指标,观察用药期间不良反应发生情况。结果治疗后,两组患者呼吸频率(RR)明显下降,血氧饱和度(SaO_2)显著提高,临床症状积分明显降低,与治疗前比较差异有统计学意义(P<0.05),观察组RR、心率(HR)及SaO_2指标变化更明显,与对照组比较差异有统计学意义(P<0.05);两组白细胞介素-5、IL-17、IL-33等炎症因子水平显著下降,各项肺功能指标显著升高,且观察组各项指标变化更明显,与对照组比较差异有统计学意义(P<0.05);观察组不良反应发生率(6.7%)与对照组(13.3%)比较,差异未见统计学意义(P>0.05)。结论相对于布地奈德混悬液雾化吸入治疗支气管哮喘,布地奈德/福莫特罗粉联合应用在缓解患者临床症状、改善其炎症反应及肺功能方面有更大优势,临床疗效好、安全性高,值得临床推广应用。

Objective To investigate the the influences of budesonide/formoterol powder inhalation on interleukin-33 （IL-33） and interleukin-17 （IL-17） levels in patients with bronchial asthma and pulmonary function. Methods Thirty patients who were diagnosed as bronchial asthma were selected and divided into the observation group and the control group according to the random digital table method, with 15 cases in each group. They were treated with antitussive, antiasthmatic and expectorant, maintaining water and electrolyte balance of basic treatment. At the same time, the patients in the observation group inhaled budesonide/formoterol powder, and the patients in the control group were treated with aerosol inhalation of budesonide suspension. The levels of IL-33, IL-17 and other inflammatory factors, maximal vital capacity （FVC） and forced respiration volume （ FEV1 ） before and after treatment in two groups were detected and compared. Results After treatment, the respiratory frequency （RR） of the patients in two groups decreased, the blood oxygen saturation （SaO2） improved, clinical symptom score decreased, there were significant differences compared with those before treatment （ P 〈 0. 05 ） ; the RR, heart rate （HR） and Sa02 index change in observation group was more obvious, there was significant difference between the two groups （P 〈0. 05）. The levels of interleukin-5, IL-17, IL-33 and other inflammatory factors in the two groups decreased, the lung function indexes increased significantly, and the indicators in the observation group changed more significantly than those in the control group （P 〈 0. 05 ）. There was no significant difference in the incidence of adverse reactions in the observation group （6. 7 % ） and the control group （ 13.3% ） （ P 〉 0. 05 ）. Conclusions Compared with budesonide inha- lation in treatment of bronchial asthma, budesonide/formoterol powder combination has more advantages in remission in patients with clinical symptoms and improve the inflammatory reaction and pulmonary function, which has better clinical curative effects and high safety, and it is worthy of clinical application.