罗氟司特对慢性阻塞性肺疾病急性加重期患者炎症及氧化应激反应的影响

Effects of roflumilast on inflammatory response and oxidative stress in patients with AECOPD

目的探讨罗氟司特对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者炎症及氧化应激反应的影响。方法选择2017年1月—2018年9月宜宾市第二人民医院呼吸内科收治的136例AECOPD患者为研究对象。按随机数字表法将患者分为观察组和对照组,各68例。2组均予以平喘、化痰、止咳、抗感染等常规治疗。对照组在常规治疗基础上予以布地奈德混悬液超声雾化吸入治疗;观察组在对照组治疗基础上予以罗氟司特治疗。2组连续治疗7 d。比较2组治疗前和治疗后肺功能[第1 s用力呼气容积(forced expiratory volume in 1 s,FEV1)、第1 s用力呼气容积/用力肺活量(forced expiratory volume in 1 s/forced vital capacity,FEV1/FVC)]、氧化应激反应指标[丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-px)、8-异前列腺素F2α(8-isoprostaglandin F2α,8-iso-PGF2α)]和炎症因子指标[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素8(interleukin-8,IL-8)、白细胞介素-17(interleukin-17,IL-17)]和不良反应。结果治疗后,观察组FEV1、FEV1/FVC高于对照组(P<0.05);观察组血清TNF-α、IL-8、IL-17水平低于对照组(P<0.05);观察组血清MDA、8-iso-PGF2α水平低于对照组,血清SOD、GSH-px水平高于对照组(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05)。结论罗氟司特联合布地奈德治疗能有效抑制AECOPD患者的炎症及氧化应激反应,改善肺功能,且不良反应轻微,值得临床推广。

Objective To invest igate the effect of rof lumilast on inf lammat ion and oxidat ive st ress in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods One hundred and thirty-six patients with AECOPD admitted to the Department of Respiratory Medicine of the Second People's Hospital of Yibin between January 2017 and September 2018 were selected as the subjects,who were evenly divided into the observation group and control group using the random number table method.Both groups were given routine treatment such as asthma relief,phlegm resolution,cough relief and anti-infection.Besides,both groups received budesonide suspension inhalation by ult rasonic atomization,but the observation group was additionally treated with rof lumilast.The indexes of lung function(FEV1,FEV1/FVC),oxidative stress response(MDA,SOD,GSHpx,8-iso-PGF2α)and inf lammator y factors(TNF-α,IL-8,IL-17)were compared between the two groups before and after treatment,so were adverse reactions.Results After treatment,the levels of FEV1,FEV1/FVC in the observation group were higher than those in the cont rol group(P<0.05),while the levels of TNF-a,IL-8 and IL-17 in the observation group were lower than those in the control group(P<0.05).The levels of MDA,and 8-iso-PGF2αin the observation group were lower than those in the cont rol g roup,while the levels of SOD and GSH-px in the serum were higher(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Rof lumilast can effectively inhibit inf lammation and oxidative stress in patients with AECOPD,improve lung function,and have few adverse reactions,which should be made more accessible.