七叶皂苷钠对慢性阻塞性肺疾病急性加重期细胞因子的影响  

Effects of sodium aescinate on cytokine during acute exacerbation in patients with chronic obstructivepulmonary disease

作　　者：王艳蕾[1] 刘智群[1] 张凤宇[2] 吴秀军[2] 郭文新[2] 刘敏[3] 

机构地区：[1]河北联合大学基础医学院,河北唐山063000 [2]唐山市丰润区人民医院内科,河北唐山064000 [3]唐山市中医医院内科,河北唐山063000

出　　处：《中国现代医学杂志》2012年第28期51-54,共4页China Journal of Modern Medicine

基　　金：河北省科学技术研究与发展计划项目(No:112761172)

摘　　要：目的探讨细胞因子在慢性阻塞性肺疾病(COPD)急性加重期中的作用及七叶皂苷钠的影响。方法将94例符合COPD急性加重期纳入标准的患者随机分为对照组(47例)和治疗组(47例),所有患者均给予常规抗感染、吸氧、化痰和平喘等常规对症治疗,治疗组在常规对症治疗基础上加用七叶皂苷钠,两组均于治疗前及治疗后2周进行肺功能检测及血气分析,同时测定血清TNF-α和IL-6,并与50例健康体检者进行比较。结果治疗前两组患者的血清TNF-α和IL-6、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)及FEV1%预计值的差异均无显著性(P>0.05);治疗前两组患者血清TNF-α和IL-6明显高于健康组(P<0.01);治疗后两组患者上述各指标均有所改善(P<0.01),但治疗组比对照组改善明显(P<0.01)。所有COPD急性加重期患者治疗前指标相关分析显示,血清TNF-α和IL-6水平与FEV1/FVC、FEV1%、PaO2间呈负相关,与PaCO2间呈正相关。结论细胞因子参与介导COPD急性加重的炎症反应,七叶皂苷钠可通过抑制细胞因子的产生,改善COPD急性加重期患者的肺功能。【Objective】 To explore the roles of serum cytokines during acute exacerbation in patients with chronic obstructive pulmonary disease（COPD） and the effects of sodium aescinate（SA）.【Methods】 Ninety-four patients with COPD were randomly divided in two groups： control group（n =47） and treatment group（n =47）.All patients were treated with routine anti-infection,oxygen inhalation,relieving phlegm and anti-asthma.The treatment group took SA based on the routine heteropathy.The changes of serum TNF-α and IL-6,the pulmonary functions,blood gas analysis were detected before and two weeks after treatment in patients of two groups,which is compared with those of 50 healthy subjects.【Results】 There are no significant differences in the value of TNF-α and IL-6,arterial partial pressure of oxygen（PaO2）,arterial partial pressure of carbon dioxide（PaCO2）,forced expiratory volume in 1 second/forced vital capacity（FEV1/FVC）,FEV 1% before treatment between two groups（P 0.05）;Serum TNF-α and IL-6 in both groups were comparatively higher than the healthy（P 0.01）.After treatment,the above-mentioned indexes of two groups were obviously ameliorated in comparison with before treatment（P 0.01）,but the treatment group is better than the control group（P 0.01）.The correlation analysis indicated that the serum levels of TNF-α and IL-6 were negatively correlated with FEV1/FVC,FEV1%,PaO2 and positively correlated with PaCO2（P 0.01）.【Conclusion】 The serum level of cytokines might be involved in the local inflammation of acute exacerbation of COPD;Sodium aescinate can improve the pulmonary functions during acute exacerbation in patients with COPD by inhibiting the generation of cytokines.

关 键 词：慢性阻塞性肺疾病 七叶皂苷钠 细胞因子 肺功能 血气分析 

分 类 号：R563[医药卫生—呼吸系统]