糖皮质激素雾化吸入对哮喘急性发作患者气道重塑的影响

Effect of Inhaled Corticosteroids on Airway Remodeling in Patients with Acute Exacerbation of Asthma

目的:探讨不同糖皮质激素给药方式对哮喘急性发作患者气道重塑及预后的影响。方法:选取160例登封市人民医院于2018年10月-2019年8月收治的支气管哮喘患者,采用随机数字法将其分成对照组和观察组,各80例,均给予沙丁胺醇气雾剂及硫酸特布他林雾化吸入治疗以控制并缓解症状;对照组同时给予静脉滴注注射用甲泼尼龙琥珀酸钠,观察组给予布地奈德粉吸入剂雾化吸入治疗。均连续治疗6周。观察并记录两组患者气道重塑、肺部功能指标,随访3个月,统计患者呼吸道感染、喘息发作次数。结果:治疗后两组气管内壁厚度(Wai)、气道平滑肌厚度(Wam)、支气管总管壁厚度(Wat)均较治疗前显著下降,且观察组显著低于对照组(P<0.05)。治疗后两组患者PEFR、FEV1/FVC、FEV1均高于治疗前,且观察组高于对照组(P<0.05)。治疗后3个月两组呼吸道感染、喘息发作次数较治疗后1个月减少,且治疗后1、3个月观察组均少于对照组(P<0.05)。结论:糖皮质激素雾化吸入治疗哮喘急性发作能够有效改善患者肺功能,抑制气道重塑的发生,治疗效果显著,患者预后良好。

Objective:To investigate the effect of different administration methods of glucocorticoid on airway remodeling and prognosis in patients with acute asthma attack.Methods:160 patients with bronchial asthma admitted to Dengfeng people's Hospital from October 2018 to August 2019 were selected and randomly divided into control group and observation group,80 cases in each group.All patients were given salbutamol aerosol and terbutaline sulfate aerosol inhalation to control and alleviate the symptoms;the control group was given methylprednisolone sodium succinate for injection,and the observation group was given budesonide The patients were treated by atomization inhalation of nide powder inhalation.All patients were treated for 6 weeks.The airway remodeling and pulmonary function indexes were observed and recorded.The patients were followed up for 3 months,and the number of respiratory tract infection and wheezing attack were counted.Results:After treatment,the thickness of trachea inner wall(Wai),airway smooth muscle thickness(Wam)and bronchial common wall thickness(Wat)of the two groups were significantly lower than those before treatment,and the observation group was significantly lower than the control group(P<0.05).After treatment,PEFR,FEV1/FVC and FEV1 of the two groups were higher than those before treatment,and the observation group was higher than the control group(P<0.05).After 3 months of treatment,the number of respiratory tract infection and wheezing attack in the two groups was less than that in 1 month after treatment,and the observation group was less than the control group at 1 and 3 months after treatment(P<0.05).Conclusion:Glucocorticoid aerosol inhalation in the treatment of acute asthma attack can effectively improve the lung function of patients,inhibit the occurrence of airway remodeling,the treatment effect is significant,and the prognosis of patients is good.