不同剂量吸入性皮质类固醇联合长效β2激动剂治疗成人持续性哮喘患者的效果及成本-效益分析

Immune Function and Cost-benefit Analysis of Different Doses of Inhaled Corticosteroids Combined with Long-actingβ2 Agonists in the Treatment of Adult Persistent Asthma

目的:探讨不同剂量吸入性皮质类固醇联合长效β2激动剂治疗成人持续性哮喘患者的免疫功能及成本-效益分析。方法:选取2019年1月—2021年3月佳木斯大学第一附属医院收治的100例成人持续性哮喘患者,随机数表法将其分为观察组(n=50)和对照组(n=50)。观察组采用大剂量吸入性皮质类固醇联合长效β2激动剂治疗,对照组采用小剂量吸入性皮质类固醇联合长效β2激动剂进行治疗,比较两组免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、血清补体C3、血清补体C4]、炎性因子水平[白细胞介素-6(lL-6)、肿瘤坏死因子-α(TNF-α)、血清C反应蛋白(CRP)]、肺部功能[用力肺活量(FVC)、第1秒用力呼气末容积占预计值百分比(FEV_(1)%pred)以及6分钟步行实验(6MWT)]以及成本-效益。结果:观察组IgA、IgG、IgM高于对照组,血清补体C3、血清补体C4低于对照组(P<0.05);观察组lL-6、TNF-α与CRP水平低于对照组(P<0.05);观察组FEV_(1)%pred、FVC以及6MWT高于对照组(P<0.05);观察组平均疗程、成本-效益均低于对照组(P<0.05)。结论:大剂量吸入性皮质类固醇联合长效β2激动剂治疗成人持续性哮喘的效果显著,可改善患者免疫功能以及炎性因子水平,提高患者的肺部功能,缩短患者治疗疗程,且成本-效益较低。

Objective:To investigate the immune function and cost-benefit analysis of different doses of inhaled corticosteroids combined with long-actingβ2 agonists in the treatment of adult persistent asthma.Methods:A total of 100 adult patients with persistent asthma who were admitted to the First Affiliated Hospital of Jiamusi University from January 2019 to March 2021 were selected and divided into observation group(n=50)and control group(n=50)by random number table method.The observation group was treated with high-dose inhaled corticosteroids combined with long-actingβ2 agonists,and the control group was treated with low-dose inhaled corticosteroids combined with long-actingβ2 agonists.The immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),serum complement C3,serum complement C4],levels of inflammatory factors[interleukin-6(lL-6),tumor necrosis factor-α(TNF-α),serum C-reactive protein(CRP)],pulmonary function[forced vital capacity(FVC),forced end-expiratory volume in 1 second as a percentage of predicted value(FEV_(1)%)pred)and the 6-minute walk experiment(6MWT)]and cost-effectiveness were compared between the two groups.Results:The levels of IgA,IgG and IgM in the observation group were higher than those in the control group,but serum complement C3 and serum complement C4 were lower than those in the control group(P<0.05);the levels of lL-6,TNF-αand CRP in the observation group were lower than those in the control group(P<0.05);the FEV_(1)%pred,FVC and 6MWT of the observation group were higher than those of the control group(P<0.05);the average course of treatment and cost-effectiveness of the observation group were lower than those of the control group(P<0.05).Conclusion:High-dose inhaled corticosteroids combined with long-actingβ2 agonists have significant effects in the treatment of adult persistent asthma,can improve patients’immune function and inflammatory factor levels,improve patients’pulmonary function,and shorten the course of treatment for patients,with low cost-effectiveness.