粉尘螨滴剂舌下含服治疗成人支气管哮喘的效果及其机制

发布时间：2018-06-04 20:48

本文选题：支气管哮喘 + 特异性免疫治疗　；参考：《山东医药》2017年39期

【摘要】：目的观察粉尘螨滴剂舌下含服治疗成人支气管哮喘的疗效,并探讨其相关机制。方法尘螨致敏的成人支气管哮喘患者80例,随机分为观察组和对照组各40例。观察组舌下含服粉尘螨滴剂,前3周为递增量期,3周后每天1次,每次3滴,共用药2年。对照组给予常规的吸氧、解痉、平喘、抗感染等治疗。分别于治疗前后对两组进行哮喘症状评分;采用哮喘控制测试(ACT)评估哮喘控制程度;使用Master Screen肺功能仪进行肺功能检测,测定指标包括第一秒用力呼气量(FEV1)、FEV1占预计值百分比(FEV1%预计值)、用力肺活量(FVC)、FVC占预计值的百分比(FVC%预计值);采集外周血,检测CD4~+CD25Foxp3~+调节性T细胞、Th3细胞及IL-10、TGF-β。结果观察组治疗后哮喘症状评分及ACT评分低于治疗前和对照组治疗后(P均0.05)。两组治疗后FEV1、FEV1%预计值、FVC、FVC%预计值均较治疗前有所提高,且观察组治疗后FEV1%预计值、FVC、FVC%预计值高于对照组(P0.05)。观察组与对照组治疗后外周血CD4~+CD25Foxp3~+调节性T细胞、Th3细胞比例及IL-10水平均升高,TGF-β水平均降低;观察组治疗后外周血Th3细胞水平、IL-10水平高于对照组,TGF-β水平低于对照组(P均0.05)。结论粉尘螨滴剂舌下含服治疗成年支气管哮喘可有效控制哮喘症状、改善肺功能,其机制可能与活化CD4~+CD25Foxp3~+调节性T细胞、Th3细胞及调节IL-10、TGF-β水平有关。
[Abstract]:Objective to observe the efficacy and mechanism of sublingual administration of Dermatophagoides farinae in the treatment of adult bronchial asthma. Methods 80 adult patients with bronchial asthma sensitized by dust mite were randomly divided into observation group (n = 40) and control group (n = 40). In the observation group, 3 drops of Dermatophagoides farinae were used once a day for 2 years after 3 weeks of increasing dosage. The control group was treated with routine oxygen inhalation, antispasmodic, antiasthmatic and anti-infection therapy. Before and after treatment, the two groups were evaluated for asthma symptoms; asthma control test (ACTT) was used to assess the degree of asthma control; Master Screen pulmonary function instrument was used to measure lung function. The first second forced expiratory volume (FEV1 / FEV1) ratio of FEV1 / FEV1 / predicted FEV1%, FVC1 / FVC / FVC% / FVC%, peripheral blood were collected and CD4 ~ CD25Foxp3- regulatory T cell Th3 cells and IL-10TGF- 尾 were detected. Results after treatment, the symptom score and ACT score of asthma in the observation group were lower than those in the control group and before treatment (P < 0.05). The predicted value of FEV1 / FEV1% in both groups was higher than that before treatment, and the predicted value of FEV1% in observation group was higher than that in control group (P 0.05). After treatment, the ratio of CD4 ~ CD25 Foxp3~ regulatory T cells and the level of TGF- 尾 in peripheral blood of observation group and control group were all increased and the level of TGF- 尾 in peripheral blood of observation group was higher than that of control group, and the level of TGF- 尾 in peripheral blood of observation group was lower than that of control group (P < 0.05). Conclusion the sublingual administration of Dermatophagoides farinae drops can effectively control the symptoms of asthma and improve lung function. The mechanism may be related to the activation of CD4 ~ CD25 Foxp3- regulatory T cells and the regulation of IL-10 TGF- 尾 level.
【作者单位】：长沙市第一医院;华中科技大学附属同济医院;
【分类号】：R562.25

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