皮质激素配合特布他林对急性加重期慢阻肺患者疗效及外周血单核细胞PD-1/PD-L1表达的影响

Effects of Corticosteroids Combined with Terbutaline on the Curative Effect of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and the Expression of PD-1/PD-L1 in Peripheral Blood Mononuclear Cells

目的皮质激素配合特布他林对急性加重期慢阻肺(AECOPD)患者疗效及外周血单核细胞PD-1/PD-L1表达的影响。方法选取2019年12月—2021年12月该院收治的88例AECOPD患者,按信封法分为观察组和对照组,各44例。对照组接受特布他林治疗,观察组在此基础上给予皮质激素治疗。比较两组治疗后的有效率、外周血程序性死亡受体(PD-1)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)及细胞程式死亡-配体(PD-L1)水平、治疗前后第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及FEV_(1)/FVC比值,并比较两组治疗前后氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))及治疗期间的不良反应情况。结果与对照组相比,治疗后观察组有效率更高(95.45%vs 79.55%),差异有统计学意义(χ^(2)=5.091,P<0.05);治疗后观察组FEV_(1)、FVC、FEV_(1)/FVC、SOD、PaO_(2)水平均更高,PD-1、PD-L1、LPO、PaCO_(2)水平更低,差异有统计学意义(P<0.05)。不良反应发生率组间对比,差异无统计学意义(P>0.05)。结论皮质激素联合特布他林治疗AECOPD的疗效较为理想,可抑制PD-1/PD-L1相互作用,增强肺功能,还能改善血气指标,且安全。

Objective To investigate the effect of corticosteroids combined with terbutaline on the curative effect of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and the expression of PD-1/PD-L1 in peripheral blood mononuclear cells.Methods A total of 88 AECOPD patients admitted to the hospital from December 2019 to December 2021 were selected and divided into an observation group and a control group according to the envelope method,with 44 cases in each.The control group received terbutaline treatment,and the observation group received corticosteroid treatment on this basis.The effective rate,peripheral blood programmed death receptor(PD-1),lipid peroxide(LPO),superoxide dismutase(SOD)and programmed cell death-ligand(PD-L1)were compared between the two groups after treatment Level,forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC ratio before and after treatment.The oxygen partial pressure(PaO_(2)),car bon dioxide partial pressure(PaCO_(2))and adverse reactions during treatment were compared between the two groups before and after treatment.Results Compared with the control group,the observation group had a higher effective rate after treatment(95.45%vs 79.55%),and the difference was statistically significant(χ^(2)=5.091,P<0.05).PaO_(2) levels were higher,PD-1,PD-L1,LPO,PaCO_(2) levels were lower,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between groups(P>0.05).Conclusion The efficacy of corticosteroid combined with terbutaline in the treatment of AECOPD is ideal,it can inhibit the interaction of PD-1/PD-L1,enhance lung function,and improve blood gas indexes,and it is safe.