糖皮质激素/长效β受体激动剂对支气管扩张患者NF-κB通路的影响及临床疗效

Effect of glucocorticoid/long-effect β agonist on NF-κB pathway in patients with bronchiectasis and its clinical efficacy

目的观察布地奈德/福莫特罗吸入剂长期使用对支气管扩张症患者NF-κB炎性通路的影响,并观察其临床疗效。方法选取我院2015年1月-2017年2月收治的支气管扩张症患者174例,随机分为对照组或观察组,每组87例。ELISA法检测患者治疗前和治疗后诱导痰液中p65、TNF-α和IL-6炎症因子的表达水平。结果治疗后观察组p65、TNF-α和IL-6炎症因子的表达水平分别为39.37±6.12μmol/L、42.61±6.43μmol/L和50.37±7.94μmol/L,显著低于对照组治疗后的60.14±11.15μmol/L、65.13±11.82μmol/L和75.12±13.68μmol/L(P<0.01)。治疗后观察组生活质量评分为45.23±7.14分,显著低于对照组治疗后的69.84±14.72分(P<0.01),治疗后观察组FEV1/FVC和FVE1/pred为68.17±10.26%和73.46±11.25%,显著高于对照组治疗后的51.57±9.48%和57.61±8.64%(P<0.05)。观察组治疗期间急性加重1.62±0.34次,显著低于对照组的2.26±0.53次(P<0.05)。结论长期布地奈德/福莫特罗吸入治疗可以减轻支气管扩张症患者局部的气道炎症反应,减少急性加重次数,改善肺功能和提高生活质量。

Objective To observe the effect of long-term use budesonide/formoterol on NF-κB pathway in patients with bronchiectasis and its clinical efficacy.Methods 174 patients with bronchiectasis from January 2015 to February 2017 were randomly divided into the control group（ n = 87） and the observation group（ n = 87）.The expression of p65,TNF-α,and IL-6 was determined by ELISA analysis.Results After treatment,the expression of p65,TNF-α,and IL-6 was 39.37 ± 6.12μmol/L,42.61 ± 6.43μmol/L,and 50.37 ± 7.94μmol/L in the observation group,which was significantly lower than that of 60.14 ± 11.15μmol/L,65.13 ± 11.82μmol/L,and 75.12 ±13.68μmol/L in the control group（ P〈0.01）.The score of life quality in the observation group was 45.23 ± 7.14,which was significantly lower than that of 69.84 ± 14.72 in the control group（ P〈0.01）.FEV1/FVC and FVE1/pred was 68.17 ± 10.26% and 73.46 ± 11.25%,which was significantly higher than that of 51.57 ± 9.48% and57.61 ± 8.64% in the control group（ P〈0.05）.The acute exacerbation times of in the observation group was 1.62± 0.34,which was significantly lower than that of 2.26 ± 0.53 in the control group（ P〈0.05）.Conclusion Long term inhalation of budesonide/formoterol can reduce airway inflammation and times of acute exacerbation,and improve lung function and quality of life in treatment of patients with bronchiectasis.