多索茶碱对COPD患者外周血EOS、eotaxin和Th17/Treg的影响  

Effect of doxofylline on EOS,eotaxin and Th17/Treg in peripheral blood of patients with chronic obstructive pulmonary disease

作　　者：葛瑜 杨凡[1] 冯玲玲[1] 李建木[1] Ge Yu;Yang Fan;Feng Lingling;Li Jianmu(Department of Pediatrics,Xiantao First People's Hospital,Xiantao 433000,China)

机构地区：[1]湖北省仙桃市第一人民医院儿科,仙桃433000

出　　处：《广西医科大学学报》2021年第6期1166-1171,共6页Journal of Guangxi Medical University

基　　金：湖北省卫生和计划生育委员会资助项目(No.WJ2017F127)。

摘　　要：目的:分析多索茶碱治疗慢性阻塞性肺疾病(COPD)的价值。方法:选择2017年1月至2019年3月湖北省仙桃市第一人民医院收治的COPD 102例,按治疗方式分为常规组48例(常规对症治疗)、联合组54例(在常规治疗基础上联合应用多索茶碱静滴),连续治疗10 d,比较两组患者疗效、肺功能指标[1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%pred)、用力肺活量(FVC)、最高呼气流量占预计值百分比(PEF%perd)]、血气指标[动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、血氧饱和度(SaO2)]、外周血嗜酸性粒细胞(EOS)、嗜酸性粒细胞趋化因子(eotaxin)水平及辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡指标的差异,记录治疗期间不良反应发生率。结果:联合组疗效分级及治疗总有效率均优于常规组(P<0.05)。治疗后,联合组肺功能指标均较常规组高(P<0.05),血气指标PaO2、SaO2高于常规组,PaCO2低于常规组(P<0.05),外周血EOS、eotaxin水平低于常规组(P<0.05),Th17、Treg、Th17/Treg比值低于常规组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:COPD患者采用多索茶碱联合治疗整体疗效较常规治疗高,可显著改善肺功能及氧合,减轻气道炎症反应,促进Th17/Treg免疫稳态恢复。Objective: To analyze the value of doxofylline in the treatment of chronic obstructive pulmonary disease(COPD). Methods: A total of 102 patients with COPD admitted to Xiantao First People’s Hospital from January 2017 to March 2019 were selected, and divided into routine group(n=48, routine symptomatic treatment)and combined group(n=54, intravenous drip of doxofylline on the basis of routine treatment) according to the treatment method. Both groups were continuously treated for 10 d. The curative effect, lung function indexes[forced expiratory volume in one second(FEV1), FEV1 as a percentage of predicted value(FEV1% pred), forced vital capacity(FVC), peak expiratory flow as a percentage of predicted value(PEF%perd)], blood gas indexes [arterial partial pressure of carbon dioxide(PaCO2), arterial partial pressure of oxygen(PaO2), oxygen saturation(SaO2)], levels of peripheral blood eosinophil(EOS) and eotaxin, and helper T cell 17(Th17)/regulatory T cell(Treg) balance were compared between the two groups. The incidence of adverse reactions during treatment was recorded. Results: The grade of curative effect and total response rate in the combined group were better than those in the routine group(P<0.05). After treatment, lung function indexes and blood gas indexes such as PaO2 and SaO2 in the combined group were higher than those in the routine group, while the PaCO2, peripheral blood EOS and eotaxin levels, Th17, Treg and Th17/Treg were lower(P<0.05). There was no significant difference inthe incidence of adverse reactions between the two groups(P>0.05). Conclusion: The overall curative effect of conventional treatmentcombined with doxo-fylline is better than that of routine treatment for patients with COPD. The former can significantly improve lung function and oxygenation, reduce airway inflammation response, and promote recovery of Th17/Treg immune homeostasis.

关 键 词：慢性阻塞性肺疾病 多索茶碱 嗜酸性粒细胞 肺功能 免疫 

分 类 号：R285[医药卫生—中药学]