痰热清联合N-乙酰半胱氨酸对老年AECOPD患者血清IL-33/sST2轴表达的影响  

Effects of Tanreqing combined with N-acetylcysteine on the expression of serum IL-33/sST2 axis in elderly pa⁃tients with acute obstructive pulmonary disease

作　　者：龙骏 张连生 顾春枫 章英彰 严萍 LONG Jun;ZHANG Liansheng;GU Chunfeng(Department of Respiratory Medicine,Tongxiang Second People's Hospital,Tongxiang 314511,China)

机构地区：[1]桐乡市第二人民医院呼吸内科,浙江桐乡314511 [2]绍兴市上虞人民医院呼吸科

出　　处：《全科医学临床与教育》2022年第11期982-986,共5页Clinical Education of General Practice

基　　金：浙江省中医药科技计划项目(2016ZQ032)。

摘　　要：目的研究痰热清联合N-乙酰半胱氨酸对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者血清白细胞介素-33(IL-33)/可溶性基质裂解素2(sST2)轴表达的影响。方法选取老年AECOPD患者122例,根据随机数字表法分为治疗组(61例)与对照组(61例)。治疗组加用痰热清联合N-乙酰半胱氨酸治疗,对照组仅予N-乙酰半胱氨酸治疗,两组均持续治疗7 d。比较两组患者治疗过程中不良反应发生情况,并比较两组治疗前后的肺功能指标、动脉血气指标、IL-33/sST2轴相关炎症细胞因子以及IL-33、sST2 mRNA和蛋白表达水平。结果治疗后,治疗组患者的IL-33、sST2 mRNA和蛋白均低于对照组,差异均有统计学意义(t分别=10.00、6.80、10.30、11.26,P均<0.05);治疗组患者治疗后的IL-4、IL-5、IL-10以及气道峰压(Ppeak)、呼气峰流速(PEF)、一秒用力呼气容积占用力肺活量(FEV1/FVC)水平均高于对照组,差异均有统计学意义(t分别=17.95、7.55、7.79、6.59、7.06、7.34,P均<0.05);治疗组患者治疗后的动脉二氧化碳分压(PaCO_(2))低于对照组,而血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))高于对照组,差异均有统计学意义(t分别=-5.02、11.40、7.12,P均<0.05)。结论痰热清联合N-乙酰半胱氨酸可明显改善老年AECOPD患者临床症状,延缓肺功能下降,利于病患预后的优化,疗效明显,其机制可能与抑制IL-33/sST2轴的活化及相关炎症因子释放有关。Objective To study the effect of Tanreqing combined with N-acetylcysteine on the expression of serum interleukin-33(IL-33)/soluble matrix lysin 2(sST2)axis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 122 elderly patients with AECOPD were selected and divided into treatment group(61 cases)and control group(61 cases)according to random number table.The treatment group was treated with Tanreqing combined with N-acetylcysteine,and the control group was treated with N-acetylcysteine only.Both groups were treated for 7 days.The adverse reactions during treatment were compared between the two groups,and the pulmonary function index,arterial blood gas index,IL-33/sST2 axis related inflammatory cytokines,IL-33,sST2 mRNA and protein expression levels before and after treatment were compared between the two groups.Results After treatment,the levels of IL-33,sST2 mRNA and protein in the treatment group were significantly lower than those in the control group(t=10.00,6.80,10.30,11.26,P<0.05).The levels of IL-4,IL-5,IL-10,Ppeak,PEF,FEV1/FVC in the treatment group were lower than those in the control group after treatment,and the differences were statistically significant(t=17.95,7.55,7.79,6.59,7.06,7.34,P<0.05).After treatment,PaCO_(2) in the treatment group was lower than that in the control group,while SaO_(2) and PaO_(2) were higher than that in the control group,the differences were statistically significant(t=-5.02,11.40,7.12,P<0.05).Conclusion Tanreqing combined with N-acetylcysteine can significantly improve the clinical symptoms of elderly AECOPD patients,delay the decline of lung function,and optimize the prognosis of patients.The mechanism may be related to the inhibition of the activation of IL-33/sST2 axis and the release of related inflammatory factors.

关 键 词：痰热清 N-乙酰半胱氨酸 慢性阻塞性肺疾病急性加重期 老年人 白细胞介素-33 可溶性基质裂解素2 

分 类 号：R563.9[医药卫生—呼吸系统]