血浆VIP含量与缓解期慢性阻塞性肺病患者吸入糖皮质激素疗效的关系

The Relationship between the Effect of Stable COPD Patients Using Inhaled Glucocorticoids and the Level of VIP in Plasma

目的 :探讨血浆中血管活性肠肽 (vasoactiveintestinalpeptide ,VIP)含量与非哮喘性缓解期慢性阻塞性肺病 (COPD)患者吸入糖皮质激素疗效的关系。方法 :采用放免法 (RIA)测定非哮喘性COPD及健康正常人 (HS)血浆VIP含量。选择 74例非哮喘性COPD患者 ,以健康正常人血浆VIP含量 x - 2S为标准 ,分为两组 :血浆VIP含量低于 x - 2S为VIPL组 (38例 ) ,血浆VIP含量高于 x - 2S为VIPH组 (36例 )。 74例均予布地奈德 80 0 μg·d-1吸入治疗 ,共 6周。治疗前、后检测常规肺功能、血浆VIP含量并进行比较。结果 :VIPL组 ,吸入糖皮质激素治疗后FEV1.0显著提高 (治疗前 1.4 9± 0 .2 6L ,治疗后 1.75± 0 .5 2L ,P <0 .0 5 ) ,有效率为 92 .1% (35 / 38) ;血浆VIP含量亦有不同程度升高 (治疗前 9.74± 4 .4 7,治疗后 15 .0 2± 7.12 )两者具有相关性 (r =0 .6 2 ,P <0 .0 1)。VIPH组治疗前、后各项指标无显著差异 (P >0 .0 5 ) ,有效率为 2 .8% (1/ 36 )。两组比较 ,有显著差异 (P <0 .0 1)。结论 :血浆VIP含量较低的缓解期COPD患者吸入糖皮质激素治疗可能有效。

Objective: To investigate the relationship between the effect of stable COPD patients in using inhaled glucocorticoids and the level of Vasoactive intestinal peptide in plasma. Methods: Use RIA method to measure level of VIP in stable COPD patients and in healthy single. We selected 74 stable COPD patients standardized by level of VIP -2S in healthy single,than divided into two groups. One is group with 38 patients, which level of VIP lower than -2S is VIP L, and another group with 38 patients VIP H is higher than -2S. All patients treated with BUD 800μg /d. in 6 weeks. Pulmonary function tests and the level of VIP were measured before and after the treatment. Results:The FEV1.0 in VIP L group were significantly improved ( from 1.49±0.26L to 1.75±0.52L)(P<0.05) and the rate of validity was 92.1%; the level of VIP in plasma was raised (from 9.74±4.47 to 15.02±7.12). And there is correlation between them(r=0.62, P<0.01). The status in VIP H group were no clinical significant difference before and after treatment(P>0.05).the rate of validity was 2.8%. The two groups have significant difference(P<0.01). Conclusion:Inhaled glucocorticoids treatment in stable COPD patients with lower plasma VIP level may result in satisfied effects.