瑞舒伐他汀对支气管哮喘患者气道炎症、肺功能及病情控制的影响

Impact of Rosuvastatin on Airway Inflammation,Pulmonary Function and Disease Control of Patients with Bronchial Asthma

目的:探讨瑞舒伐他汀对支气管哮喘患者气道炎症、肺功能及病情控制的影响。方法:选取2019年1-12月于大连大学附属新华医院呼吸内科就诊的支气管哮喘患者60例,按照随机数字表法分为治疗组和对照组,各30例。对照组患者给予沙美特罗替卡松粉吸入剂治疗,治疗组患者在对照组的基础上给予瑞舒伐他汀钙片治疗。治疗前和治疗12周后,比较两组血清中IL-4、IL-5、IL-13及IL-17水平;比较两组的第一秒用力呼气容积占预计值百分比(FEV1%pred)、呼气峰流速占预计值百分比(PEF%pred)和哮喘控制测试(ACT)评分。结果:治疗12周后,两组患者血清中IL-4、IL-5、IL-13及IL-17水平均较治疗前明显降低,差异均有统计学意义(P<0.05);且治疗组患者治疗后各项指标均较对照组降低更加明显,差异均有统计学意义(P<0.05)。治疗12周后,两组患者FEV1%pred、PEF%pred、ACT评分均较治疗前显著升高,差异均有统计学意义(P<0.05);且治疗组患者治疗后各项指标均较对照组升高更加显著,差异均有统计学意义(P<0.05)。结论:瑞舒伐他汀可通过纠正Th1/Th2免疫失衡,抑制Th17细胞分化,减少IL-17的分泌而发挥免疫调节作用,且增强糖皮质激素的抗炎作用,从而减轻哮喘气道炎症,改善肺功能,提高哮喘临床控制水平,为哮喘治疗提供新方向。

Objective:To explore the impact of Rosuvastatin on airway inflammation,pulmonary function and disease control of patients with bronchial asthma.Method:From January 2019 to December 2019,60 patients with bronchial asthma were selected in the department of respiratory,Affiliated Xinhua Hospital of Dalian University.According to the expression of random numbers,they were divided into treatment group and control group,30 cases in each group.The patients in the control group were given Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation,the patients in the treatment group were given Rosuvastatin Calcium Tablets on the basis of the control group.Before and after 12 weeks of interventions,serum levels of IL-4,IL-5,IL-13 and IL-17 were compared between the two groups;the percentages of forced expiratory volume in the first second(FEV1%pred),peak expiratory flow in the first second(PEF%pred),and asthma control test(ACT)scores were compared between the two groups.Result:After 12 weeks of treatments,the serum levels of IL-4,IL-5,IL-13 and IL-17 were significantly decreased in both groups,the differences were statistically significant(P<0.05);above indicators in the treatment group after treatment were significantly lower than those in the control group(P<0.05).After 12 weeks of treatments,FEV1%pred,PEF%pred and ACT scores were significantly increased in both groups,the differences were statistically significant(P<0.05);above indicators in the treatment group after treatment were significantly higher than those in the control group(P<0.05).Conclusion:Rosuvastatin can exert immune regulation through correcting the imbalance of Th1/Th2,restraining Th17 cell differentiation,decreasing the level of IL-17,and enhance anti-inflammatory effect of glucocorticoids,thereby can relieve the airway inflammation,improve pulmonary function,raise the level of asthma control,and provide a new direction for asthma treatment.