细菌溶解产物联合常规对症治疗对COPD急性加重患者气道功能、炎症反应及免疫应答的影响

Effect of bacterial lysates combined with conventional symptomatic treatment on airway function,inflammatory response and immune response in patients with acute exacerbation of COPD

目的 研究细菌溶解产物联合常规对症治疗对慢性阻塞性肺疾病(COPD)急性加重患者气道功能、炎症反应及免疫应答的影响。方法 前瞻性选择2015年6月至2019年2月期间北华大学附属医院收治的COPD急性加重患者作为研究对象并随机分为接受细菌溶解产物联合常规对症治疗的观察组、接受常规对症治疗的对照组。治疗前及治疗后3个月时,测定肺功能指标第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及外周血中炎症指标肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白介素-8(IL-8)、趋化因子C-C-基元配体16(CCL16)、趋化因子C-C-基元配体18(CCL18)、免疫指标免疫球蛋白A(Ig A)、补体C3及C4、辅助T细胞17(Th17)、调节性T细胞(Treg)的含量。结果与治疗前比较,两组患者治疗后3个月时FEV1、FEV1/FVC、FEV1/预计值的水平以及外周血中Ig A的含量均显著升高,外周血中TNF-α、IFN-γ、IL-8、CCL16、CCL18、Th17、Treg、C3、C4的含量均显著降低(P <0. 05),且观察组患者治疗后3个月时的FEV1、FEV1/FVC、FEV1/预计值水平以及外周血中Ig A含量均高于对照组,外周血中TNF-α、IFN-γ、IL-8、CCL16、CCL18、Th17、Treg、C3、C4的含量均低于对照组(P <0. 05)。结论 细菌溶解产物联合常规对症治疗COPD急性加重能够更为有效地改善气道功能、抑制炎症反应、调节免疫应答。

Objective To study the effects of bacterial lysates combined with conventional symptomatic treatment on airway function,inflammatory response and immune response in patients with acute exacerbation of COPD.Methods The patients with acute exacerbation of COPD treated in our hospital during June 2015 to February 2019 were selected as the research subjects and randomly divided into the observation group receiving bacterial lysates combined with routine symptomatic treatment and the control group receiving routine symptomatic treatment.Before treatment and 3 months after treatment,the pulmonary function index forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and inflammatory index TNF-α,IFN-γ,IL-8,CCL16,CCL18,immune index IgA,C3,C4,Th17,Treg in peripheral blood were measured.Results Compared with before treatment,the levels of FEV1,FEV1/FVC,FEV1/predicted value and the content of IgA in the peripheral blood significantly increased,the content of TNF-α,IFN-γ,IL-8,CCL16,CCL18,Th17,Treg,C3,C4 in peripheral blood significantly decreased and the levels of FEV1,FEV1/FVC,FEV1/predicted value and the content of IgA in the peripheral blood of observation group were significantly higher than control group,the content of TNF-α,IFN-γ,IL-8,CCL16,CCL18,Th17,Treg,C3,C4 in peripheral blood were significantly lower than control group.Conclusion Bacterial lysates combined with conventional symptomatic treatment for acute exacerbation of COPD can more effectively improve airway function,inhibit inflammatory response and regulate immune response.