氨茶碱和糖皮质激素治疗对哮喘患者嗜酸性粒细胞凋亡的作用  

The Apoptosis Effects of Aminophylline and Glucocorticoid on Eosinophil of Patients with Asthma

作　　者：陈丽萍[1] 刘洋[1] 薛红[1] 王昌亮[2] 张国华[2] 

机构地区：[1]沈阳医学院沈洲医院呼吸内科,辽宁沈阳110002 [2]中国医科大学法医学院法医病理学教研室

出　　处：《沈阳医学院学报》2009年第3期134-139,共6页Journal of Shenyang Medical College

摘　　要：目的:测定诱导痰及血中嗜酸性粒细胞(Eos)数目及凋亡率,比较氨茶碱、糖皮质激素及联合用药对支气管哮喘患者Eos凋亡的作用。方法:对2000年8月至2007年12月期间我院门诊及住院的90例支气管哮喘患者,随机分成三组,30例健康者为对照组。用3%高渗盐水超声雾化吸入进行痰液诱导,采集血样,经分离纯化Eos后,计数,并以台盼蓝染色检测细胞存活率,分别以TUNEL法和流式细胞术测定患者用药前、后诱导痰及血中Eos凋亡状况。结果以统计学分析。结果:(1)血清及诱导痰Eos数目二者具有正相关。(2)三组患者治疗前、后肺功能(FEV1.0)及气道反应性(PD20FEV1.0)测定值比较,差异有显著性(P<0.05)。茶碱、激素两组间比较,差异无显著性,而联合用药组与茶碱、激素组间两两比较,差异有显著性(P<0.05)。(3)各组血清与诱导痰Eos数目及百分率均与FEV1.0呈负相关,与PD20FEV1.0呈负相关。(4)诱导痰及外周血中,三组给药前后,凋亡率均有显著性差异(P<0.01);凋亡率茶碱、激素组间两两比较,无显著性差异,茶碱、联合用药及激素、联合用药组间比较,差异有显著性(P<0.05);茶碱、激素、联合用药三组分别同对照组比较,差异有显著性(P<0.01),并且各组诱导痰及外周血中Eos凋亡率呈正相关。(5)Eos用药前坏死率为(4±1)%,用药后各组与用药前比较,细胞坏死率(18±4)%、(19±3)%和(21±3)%显著增加(P<0.01)。结论:(1)联合用药后,诱导痰和血中Eos凋亡数量较单独应用氨茶碱或激素的为多,说明二者联合用药治疗哮喘有协同作用。(2)诱导痰技术在哮喘患者气道炎症研究方面,无创安全、简便易行,本实验中血清、诱导痰Eos数目及凋亡率具有正相关,为临床Eos凋亡测定开辟了新的更有效的途径。Objective： To count the Eos in patients＇ induced sputum and blood to reflect the difference between sputum samples and blood samples in bronchial inflammation; to research apoptosis effects of aminophylline and glucocorticoid on Eos in patients＇ induced sputum and blood with asthma, provide new theoretical basis for treatment of asthma, which can direct clinical work better. Methods ： Ninty patients with bronchial asthma were randomly divided into three groups ： Aminophylline group, Glucocorticoid group and Combination group. Thirty healthy people make up a control group. The patients＇ FEV1.0 and PD20 FEV1.0 were measured before and after treatments. High osmotic pressure of saline water was used to ultrasonic atomizing inhalation for inducing sputum 20ml before and after treatments, collect blood samples, and through centrifugation and filtration, get Eos samples. Count Eos cells, test cell viability with trypan blue, and apply TUNEL assay and FCM respectively to determine Eos apoptosis in groups. Use statistics methods to analyze the results. Results： （ 1 ） There were positive correlations between Eos counts and percentage of blood serum and those of sputum. （2） Compare the values of FEVI.0 and PD20 FEV1.0 of the three groups before and after treatments： there were significant differences （P 〈 0. 05 ） in each group ; significant differences between Combination group and Aminophylline group as well as Glucocorticoid group and Combination group; no significant differences between Aminophylline group and Glucocorticoid group. （3） The counts and percentage of Eos in serum and induced sputum of each group were significantly negatively correlated with FEV1.0, as well as with PD20 FEV1.0. （4） In both sputum and blood detection, the apoptosis rates had significant differences in each group before and after treatment （ P 〈 0. 01 ） ; there were significant difference （ P 〈 0. 05 ） between Aminophylline group and Combination group, as well as Glucocorticoid group and Combi

关 键 词：氨茶碱 糖皮质激素 嗜酸性粒细胞 凋亡 TUNEL凋亡检测 流式细胞术 诱导痰 

分 类 号：R285.5[医药卫生—中药学] R562.25[医药卫生—中医学]