脾氨肽联合多索茶碱治疗老年支气管哮喘的临床效果及对辅助性T细胞1/辅助性T细胞2免疫平衡的影响

Therapeutic effect of splenic aminopeptide combined with doxofylline on senile bronchial asthma and its effect on the immune balance of T helper cell 1/T helper cell 2

目的探究脾氨肽联合多索茶碱治疗老年支气管哮喘的临床效果及对辅助性T细胞1(Th1)/Th2免疫平衡的影响。方法选取2016年10月至2019年10月空军军医大学第一附属医院明确诊断为老年支气管哮喘患者102例,应用随机数字表法分为对照组及观察组,各51例。对照组在常规治疗基础上联合多索茶碱片口服治疗,观察组在对照组治疗基础上联合脾氨肽冻干粉治疗,2组均治疗1个月。比较2组患者治疗前后Th1/Th2免疫平衡指标、动脉血气指标、肺功能指标水平,以及临床疗效和不良反应发生率。结果治疗前,2组血清Th1/Th2免疫平衡相关指标、动脉血气指标、肺功能指标水平比较差异均无统计学意义(均P>0.05);治疗后,2组血清γ干扰素、白细胞介素33水平和动脉血二氧化碳分压均低于治疗前,且观察组均低于对照组[(56±5)ng/L比(61±5)ng/L、(221±20)ng/L比(259±23)ng/L、(40±4)mmHg(1 mmHg=0.133 kPa)比(46±4)mmHg],γ干扰素/白细胞介素33比值、动脉血氧饱和度、动脉血氧分压、呼气峰流速以及第1秒用力呼气容积/用力肺活量比值均高于治疗前,且观察组均高于对照组[(0.28±0.10)比(0.24±0.08)、(92±9)%比(86±8)%、(75±7)mmHg比(66±6)mmHg、(3.4±0.7)L/s比(2.8±0.6)L/s、(80±9)%比(72±8)%](均P<0.05)。观察组治疗总有效率高于对照组[96.1%(49/51)比80.4%(41/51)](χ^2=6.044,P=0.014),不良反应发生率与对照组比较差异无统计学意义(P=0.757)。结论脾氨肽联合多索茶碱可有效纠正老年支气管哮喘患者体内Th1/Th2失衡状态,改善其肺功能及动脉血气,临床疗效显著。

Objective To explore the clinical effect of splenic aminopeptide combined with doxofylline in the treatment of elderly bronchial asthma and its effect on the immune balance of T helper cell 1(Th1)/Th2.Methods From October 2016 to October 2019,102 elderly patients with bronchial asthma admitted to the First Affiliated Hospital of Air Force Military Medical University were enrolled.According the random number table,they were divided into control group and observation group,with 51 cases in each group.Control group was given oral doxofylline tablets on the basis of conventional treatment,and observation group was given spleen aminopeptide lyophilized powder on the basis of control group.Both groups were treated for 1 month.The levels of Th1/Th2 immune balance indexes,arterial blood gas indexes,lung function indexes,clinical efficacy and incidence of adverse reactions before and after treatment were compared between two groups.Results Before treatment,there were no significant differences in serum Th1/Th2 immune balance-related indexes,arterial blood gas indexes,and lung function indexes between the two groups(all P>0.05);after treatment,the serum interferon-γand interleukin(IL)-33 and partial pressure of carbon dioxide levels in the two groups were lower than those before treatment,which in observation group were lower than those in control group[(56±5)ng/L vs(61±5)ng/L,(221±20)ng/L vs(259±23)ng/L,(40±4)mmHg vs(46±4)mmHg,],interferon-γ/IL-33,oxygen saturation,oxygen pressure,peak expiratory flow,forced expiratory volume in 1 second/forced vital capacity levels in two groups were higher than before treatment,and those in observation group were higher than those in control group[(0.28±0.10)vs(0.24±0.08),(92±9)%vs(86±8)%,(75±7)mmHg vs(66±6)mmHg,(3.4±0.7)L/s vs(2.8±0.6)L/s,(80±9)%vs(72±8)%,all P<0.05].The total effective rate of treatment in observation group was higher than that in control group[96.1%(49/51)vs 80.4%(41/51)](χ2=6.044,P=0.014),and there was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.757).Conclusion Splenic aminopeptide combined with doxofylline can effectively correct the Th1/Th2 imbalance in elderly patients with bronchial asthma,and it can also improve pulmonary function and arterial blood gas.