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布地奈德福莫特罗粉吸入剂联合脾氨肽治疗支气管哮喘急性发作的效果研究

Effect of budesonide formoterol powder inhalation combined with spleen aminopeptide in treatment of patients with acute attack of bronchial asthma

    摘要
  • 摘要:
      目的  观察布地奈德福莫特罗粉吸入剂联合脾氨肽治疗支气管哮喘急性发作的效果。
      方法  将98例支气管哮喘急性发作患者随机分为对照组和研究组，每组49例。对照组给予布地奈德福莫特罗治疗，研究组给予布地奈德福莫特罗联合脾氨肽治疗。比较2组症状改善情况、肺功能指标第1秒用力呼气量（FEV1）、第1秒用力呼气量与肺活量的比值（FEV1/FVC）、晨间测定最大呼气峰值流速（PEFam）、晚间测定最大呼气峰值流速（PEFpm）、辅助性T细胞1/辅助性T细胞2（Th1/Th2）漂移状况及微小RNA-146a（miR-146a）表达水平。
      结果  研究组憋喘、咳嗽、哮鸣音、湿啰音症状改善时间均短于对照组，差异有统计学意义（P < 0.05）。治疗后，2组FEV1、FEV1/FVC、PEFam、PEFpm均高于治疗前，且研究组FEV1、FEV1/FVC、PEFam、PEFpm均高于对照组，差异有统计学意义（P < 0.05）。治疗后，2组白细胞介素-2（IL-2）、γ-干扰素（IFN-γ）、Th1、Th1/Th2均高于治疗前，白细胞介素-5（IL-5）、白细胞介素-13（IL-13）、Th2均低于治疗前，且研究组IL-2、IFN-γ、Th1、Th1/Th2均高于对照组，IL-5、IL-13、Th2均低于对照组，差异有统计学意义（P < 0.05）。治疗后，2组miR-146a表达水平均低于治疗前，且研究组miR-146a表达水平低于对照组，差异有统计学意义（P < 0.05）。
      结论  布地奈德福莫特罗联合脾氨肽治疗支气管哮喘急性发作效果显著，能加快症状缓解，改善肺功能，其机制可能与逆转Th1/Th2漂移方向、下调miR-146a表达水平有关。

     

    Abstract:
      Objective  To observe the effect of budesonide formoterol powder inhalation combined with spleen aminopeptide in treatment of patients with acute attack of bronchial asthma.
      Methods  A total of 98 patients with acute attack of bronchial asthma were randomly divided into control group and study group, with 49 cases in each group. The control group was treated with budesonide formoterol, while the study group was treated with budesonide formoterol and spleen aminopeptide. Improvement of symptoms, lung function indexesforced expiratory volume in the first second (FEV1), ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), maximum peak expiratory flow rate in the morning (PEFam) and maximum peak expiratory flow rate in the evening (PEFpm), helper T cell 1/helper T cell 2(Th1/Th2) drift and microRNA-146a (miR-146a) expression level were compared between the two groups.
      Results  The improvement time of symptoms such as asthma, cough, wheezing and wet rale in the study group was significantly shorter than that in the control group (P < 0.05). After treatment, FEV1, FEV1/FVC, PEFam and PEFpm in both groups were significantly higher than those before treatment, and FEV1, FEV1/FVC, PEFam and PEFpm in the study group were significantly higher than those in the control group (P < 0.05). After treatment, interleukin-2 (IL-2), interferon-γ (IFN-γ), Th1 and Th1/Th2 increased significantly, while interleukin-5 (IL-5), interleukin-13 (IL-13) and Th2 decreased significantly in both groups, and IL-2, IFN-γ, Th1 and Th1/Th2 in the study group were significantly higher than those in the control group, while IL-5, IL-13 and Th2 were significantly lower than those in the control group (P < 0.05). After treatment, the expression level of miR-146a in both groups was significantly lower than that before treatment, and the expression level of miR-146a in the study group was significantly lower than that in the control group (P < 0.05).
      Conclusion  Budesonide formoterol combined with spleen aminopeptide has a significant effect in the treatment of patients with acute attack of bronchial asthma, which can accelerate the remission of symptoms and improve lung function, and its mechanism may be related to reversing the drift direction of Th1/Th2 and down-regulating the expression level of miR-146a.

     

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