噻托溴铵联合香菇多糖注射液对COPD稳定期患者免疫功能及血清HMG-B1、mcp-1水平变化的影响

Effects of tiotropimn bromide combined with lentinan injection on immune function and serum high mobility group proteins and monocyte chemoattractant protein-1 levels in chronic obstructive pulmonary disease patients in stable period

目的 探讨噻托溴铵联合香菇多糖注射液对慢性阻塞性肺疾病 （COPD）稳定期患者免疫功能及血清高迁移率族蛋白B1 （HMGB1）、单核细胞趋化蛋白-1 （MCP-1）水平变化的影响。方法 选取我院103例COPD稳定期患者,按照随机数字表法分组,对照组51例给予噻托溴铵治疗,观察组52例给予噻托溴铵联合香菇多糖注射液治疗,观察比较2组临床疗效及治疗前后肺功能各指标 [第1秒用力呼气容积 （FEV1）及FEV1/用力肺活量 （FVC）]、免疫功能各指标 [CD3＋、CD4＋、免疫球蛋白G （IgG）、IgM]、血清HMGB1、MCP-1水平变化情况,并统计2组不良反应发生情况。结果 观察组治疗总有效率为88 46% （46/52）,高于对照组70 59% （36/51）,差异有统计学意义 （χ^2=5 067,P 〈0.05）;治疗3个月后观察组FEV1 及FEV1/FVC均高于对照组,差异有统计学意义 （t=10 706、7 017,P值均〈0.05）;观察组治疗3个月后CD3＋、CD4＋及IgG、IgM均高于对照组,差异有统计学意义 （t=5 490、6.114、19.379、7.588,P 值均〈0.05）;治疗3个月后观察组血清 HMGB1、MCP-1水平均低于对照组,差异有统计学意义 （t=7 461、16 790,P 值均〈0.05）;观察组不良反应发生率为11 54% （6/52）,对照组为7 84% （4/51）,组间对比差异无统计学意义 （χ^2=0 090,P 〉0.05）。结论 香菇多糖注射液联合噻托溴铵有助于改善COPD稳定期患者免疫功能及血清 HMGB1、MCP-1水平,促进肺功能恢复,疗效显著,用药安全性高。

Objective To explore the effects of tiotropium bromide combined with lentinan injection on immune function and serum high mobility group proteins （HMGB1） and monocyte chemoattractant protein-1 （MCP-1） levels in chronic obstructive pulmonary disease （COPD） patients in stable period. Methods A total of 103 patients with stable COPD in our hospital were randomly divided into 2 groups. In the control group, 51 cases were treated with tiotropium bromide, and 52 cases in the observation group were treated with tiotropium bromide combined with lentinan injection. Observe and compare the clinical efficacy and the pulmonary function indexes [forced expiratory volume in one second （FEV1） and FEV1/forced vital capacity （FVC）], immune function indexes [-CD3＋ , CD4＋ , immunoglobulin G （IgG）, IgM], and the serum HMGB1, MCP-1 level changes of the two groups before and after the treatment. The incidence of adverse reactionsin the two groups was statistically analyzed. Results The total effective rate of the observation group was 88.46% （46/52）, higher than that of the control group 70.59% （36/51） （ X2 = 5.067, P〈0.06）. After 3 months treatment, the FEV1 and FEV1/FVC in the observation group were higher than those in the control group（ t = 10. 706,7. 017, both P d0.05）. After 3 months treatment, CD3＋, CD4＋, IgG and IgM in the observation group were higherthan those in the control group （ t = 5. 490,6. 114,19. 379,7. 588, all P〉0.05）. After 3 months treatment, the serum levels of HMGB1 and MCP-1 in the observation group were lower than those in the control group （ t 7. 461,16. 790, both P 〈 0.05 ）. The incidence of side effects was 11.54 % （6/52） in the observation group and 7.84% （4/51） in the control group. There was no significant difference between the two groups （X2= 0. 090, P 〉0.05）. Conclusions Lentinan injection combined with tiotropium bromide can improve the immune function and serum HMGB1 and MCP-1 levels in patients with stable COPD, and promote the recovery of lung function. The curative effect is remarkable, and the safety is high.