乌美溴铵维兰特罗治疗稳定期支气管扩张症的疗效及对NF-κB通路介导炎症反应的影响

Efficacy of Umeclidinium Bromide and Vilanterol Trifenatate in the treatment of stable bronchiectasis and its effect on NF⁃κB pathway mediated inflammatory response

目的 研究乌美溴铵维兰特罗治疗稳定期支气管扩张症的疗效及对核因子-κB(NF-κB)通路介导炎症反应的影响。方法 选择2020年1月至2023年1月期间广东医科大学第一临床医学院、东莞市松山湖中心医院收治的稳定期支气管扩张症患者,随机分为接受噻托溴铵粉吸入剂治疗的对照组和接受乌美溴铵维兰特罗治疗的观察组,每组各38例。于治疗前和治疗后6个月评价两组临床症状评分和呼吸困难评分,检测比较两组第一秒用力呼气容积(FEV1)/用力肺活量(FVC)、FEV1占预计值百分比(FEV1/pred)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))及血清、痰诱导液中肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、p65 NF-κB水平。结果 治疗后6个月时,两组的临床症状评分、呼吸困难评分、血清及痰诱导液中TNF-α、IL-6、p65 NF-κB的水平均低于治疗前,且观察组患者低于对照组,差异有统计学意义(P<0.05);两组FEV1/FVC、FEV1/pred、PaO_(2)均高于治疗前,且观察组患者高于对照组,差异有统计学意义(P<0.05)。结论 乌美溴铵维兰特罗治疗稳定期支气管扩张症的疗效优于噻托溴铵,与之相关的分子机制可能是抑制NF-κB通路介导的炎症反应。

Objective To study the efficacy of umeclidinium bromide and vilanterol trifenatate in the treatment of stable bronchiectasis and the effect of nuclear factor-κB(NF-κB)pathway mediated inflammatory response.Methods Patients with stable bronchiectasis admitted to The First Clinical Medical College of Guangdong Medical University,Dongguan Songshan Lake Central Hospital from January 2020 to January 2023 were randomly divided into the control group receiving tiotropium bromide powder inhalation and the observation group receiving umeclidinium bromide and vilanterol trifenatate,with 38 cases in each group.Before treatment and 6 months after treatment,clinical symptom score and dyspnea score were evaluated,forced expiratory volume in the first second(FEV1)/forced vital capacity(FVC),the percentage of FEV1 to the prediction value(FEV1/pred),partial pressure of arterial oxygen(PaO_(2)),partial pressure of arterial carbon dioxide(PaCO_(2)),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and p65 NF-κB levels in serum and sputum induced fluid were detected and compared.Results At 6 months after treatment,clinical symptom score,dyspnea score,contents of TNF-α,IL-6 and p65 NF-κB in serum and sputum induction fluid of 2 groups were lower than before treatment,with statistical significance(P<0.05),and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).The FEV1/FVC,FEV1/pred and PaO_(2) were higher than before treatment,and the differences were statistically significant(P<0.05),and the patients in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The efficacy of Umetamide Veranterol in the treatment of stable bronchiectasis is better than that of Titoronium,and the related molecular mechanism may be the inhibition of NF-κB pathway mediated inflammatory response.