布地奈德福莫特罗对支气管哮喘患者T淋巴细胞及相关细胞因子的影响

Effect of symbicort on Th1,Th2,Th17,Treg expression and related cytokines in patients with bronchial asthma

目的探讨布地奈德福莫特罗粉吸入剂对支气管哮喘患者外周血T淋巴细胞亚群比例及相关细胞因子水平的影响。方法选取2017年1月-2018年6月本院收治的60例支气管哮喘患者。随机分为对照组和治疗组,各30例,对照组行常规对症治疗,治疗组在对照组的基础上加用布地奈德福莫特罗粉吸入剂。采用流式细胞仪测定外周血Th1、Th2、Th17及Treg细胞比例,ELISA法检测IL-2、IL-4、IL-6、IL-10、IL-17和IFN-γ水平。比较2组患者治疗前后肺功能、外周血T淋巴细胞亚群比例和细胞因子水平。结果治疗后,2组患者FEV1、FEV1/FVC和FEV1预计值较治疗前均显著升高,且治疗组各指标的改善幅度更大(P<0.05)。2组患者的Th1、Th17比例较治疗前明显下降,Th2、Treg比例较治疗前显著上升,且治疗组各T淋巴细胞亚群比例改善幅度更大,差异均有统计学意义(P<0.05)。2组患者IL-2、IL-17和IFN-γ水平较治疗前下降,IL-4、IL-6和IL-10水平较治疗前升高,且治疗组各细胞因子水平改善幅度更大,差异均有统计学意义(P<0.05)。结论布地奈德福莫特罗粉吸入剂能够有效纠正哮喘患者外周血T淋巴细胞亚群比例失衡,调节细胞因子释放,改善患者肺功能。

Objective To investigate the effect of symbicort on the proportion of T lymphocyte subsets and the level of related cytokines in peripheral blood of patients with bronchial asthma.Methods A total of 60 cases of bronchial asthma admitted to our hospital from Jan.2017 to Jun.2018 were selected.They were randomly divided into control group and treatment group,with 30 cases in each group.The control group was treated with routine symptomatic treatment,while the treatment group was treated with symbicort on the basis of the control group.The ratio of Th1,Th2,Th17 and Treg cells in peripheral blood was measured by flow cytometry.The levels of IL-2,IL-4,IL-6,IL-10,IL-17 and IFN-γ were detected by ELISA.The lung function,the proportion of peripheral blood T lymphocyte subsets and the level of cytokines were compared between the two groups before and after treatment.Results After treatment,the predicted values of FEV1,FEV1/FVC and FEV1 in the two groups were significantly higher than those before treatment,and the improvement of each index in the treatment group was greater(P<0.05).The proportion of Th1 and Th17 in the two groups was significantly lower than that before treatment,and the proportions of Th2 and Treg were significantly higher than that before treatment,and the proportion of T lymphocyte subsets in the treatment group improved more significantly,and the differences were statistically significant(P<0.05).The levels of IL-2,IL-17 and IFN-gamma in the two groups were lower than those before treatment,while the levels of IL-4,IL-6 and IL-10 were higher than those before treatment,and the levels of cytokines in the treatment group improved more significantly,with the differences statistical significance(P<0.05).Conclusion Symbicort can effectively correct the imbalance of T lymphocyte subsets in peripheral blood of asthmatic patients,regulate the release of cytokines,and improve the lung function of patients with asthma.