家庭氧疗对COPD患者Th1/Th2平衡的影响  

The Effect of Home Oxygen Therapy on Th1/Th2 Balance in Patients with Chronic Obstructive Pulmonary Disease

作　　者：徐立强 于立杰 汤业磊[2] 

机构地区：[1]浙江省杭州市江干区九堡镇社区卫生服务中心内科,310019 [2]浙江大学医学院附属第二医院,310009

出　　处：《放射免疫学杂志》2010年第2期209-211,共3页Journal of Radioimmanology

摘　　要：目的:探讨家庭氧疗对COPD患者Th1/Th2平衡的影响。方法:将60例重度COPD稳定期患者随机分为氧疗组和非氧疗组,每组各30例,氧疗组给予家庭氧疗,非氧疗组则不予家庭氧疗。观察两组氧疗前后单个核细胞(PBMC)培养上清液中IL-4/IFN-γ比值的变化和临床疗效。结果:治疗前,氧疗组、非氧疗组IL-4/IFN-γ比值大致相仿(P>0.05),但明显高于体检组。治疗后,氧疗组IL-4/IFN-γ比值明显下降(P<0.05),非氧疗组变化不明显(P>0.05)。氧疗组显效率16.7%,有效率93.3%;非氧疗组显效率0%,有效率6.7%;两组疗效经Ridit检验,差异有显著性意义(P<0.05)。氧疗组急性加重发作(AECOPD)总人次为46次,非氧疗组AECOPD总人次为87次,氧疗组明显少于非氧疗组(P<0.05)。结论:COPD患者存在Th1/Th2细胞平衡紊乱,长期家庭氧疗逆转了Th细胞的分化异常,提高了患者的免疫功能。Objective To investigate the effect of home oxygen therapy on Th1/Th2 balance in patients with chronic obstructive pulmonary disease （COPD）. Methods Totally 60 patients with advanced COPD in stable phase were randomly divided into equal-numbered oxygen and non-oxygen therapy groups. In the oxygen therapy group,the patients were treated with oxygen in home,1~2L/min,15h/d for 3 months. The changes of peripheral blood mononuclear cell （PBMC） culture supernatant IL-4,INF-γ contents and IL-4/IFN-α ratio as well as the clinical outcomes were observed in all these patients and 30 controls. Results Before treatment,the IL-4/IFN-γ ratios in the two groups of patients were not significantly different （P0.05）,but were significantly higher than those in the controls. After treatment,IL-4/IFN-γ ratio decreased significantly in the oxygen therapy group （vs before treatment,P0.05）,while such changes were not obvious in the non-oxygen therapy group （P0.05）. Clinically the significantly effective rate and total response rate was 16.7% and 93.3% respectively in the oxygen therapy group,but only 0% and 6.7% in the non-oxygen therapy group （P0.05）. Conclusion Imbalance of Th1/Th2 cell immuno-fuction was presentin COPD patients with Th2 predominance,which might be reversed with long term home oxygen therapy with improvement of resistance against infection.

关 键 词：慢性阻塞性肺疾病 氧疗 Γ-干扰素 白介素-4 

分 类 号：R289.5[医药卫生—方剂学]