福多司坦对稳定期中性粒细胞为主型COPD患者诱导痰成分的影响分析  

Analysis of the effect of fudosteine on induced sputum components in patients with stable neutrophil-dominated COPD

作　　者：李占波 杜开锋 姜志龙 高佳萌 陈梦捷 马圆 陈智鸿[1] LI Zhanbo;DU Kaifeng;JIANG Zhilong;GAO Jiameng;CHEN Mengjie;MA Yuan;CHEN Zhihong(Department of Pulmonary and Critical Care Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Respiratory and Critical Care Medicine,Qingpu Hospital,Fudan University,Shanghai 201700,China;Department of Respiratory and Critical Care Medicine,Minhang Hospital,Fudan University,Shanghai 201100,China)

机构地区：[1]复旦大学附属中山医院呼吸与危重症医学科,上海200032 [2]复旦大学附属中山医院青浦分院呼吸与危重症医学科,上海201700 [3]复旦大学附属闵行医院呼吸与危重症医学科,上海201100

出　　处：《中国临床药理学与治疗学》2024年第4期362-369,共8页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金(82270026);上海市重中之重临床建设项目(2017ZZ02013)。

摘　　要：目的:观察化痰药物福多司坦对稳定期中性粒细胞为主型慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者诱导痰细胞组分和肺功能的影响。方法:选取2019年10月至2022年10月收治的53例稳定期COPD患者,分为福多司坦组及安慰剂组,安慰剂组采取常规治疗,福多司坦组在常规治疗的基础上加用福多司坦。两组治疗6个月,治疗前后详细记录患者临床症状[圣乔治呼吸问卷(SGRQ评分)、慢阻肺患者自我评估测试问卷(CAT评分)和改良版英国医学研究委员会呼吸困难问卷(MMRC评分),咳嗽、咳痰评分(BCSS评分)]、肺功能指标、诱导痰细胞学等相关检查结果,分析并比较。结果:(1)两组治疗后和基线相比,肺功能指标第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、两者的比值(FEV1/FVC),均得到改善,差异均有统计学意义(P<0.05)。但治疗后,两组组间比较肺功能各项指标除肺一氧化碳弥散量占预计值的百分比(DLCO%pre)具有差异外(福多司坦组DLCO%pre高于安慰剂组),其余指标均无统计学差异。(2)两组治疗后,福多司坦组诱导痰细胞总数,中性粒细胞计数均低于安慰剂组。与基线各组分细胞数相比,福多司坦组诱导痰细胞总数,中性粒细胞计数明显降低(P<0.05)。结论:稳定期中性粒细胞为主型COPD患者接受福多司坦治疗,可以改善肺功能,降低诱导痰细胞总数和中性粒细胞总数,从而改善气道炎症。AIM:To observe the effect of fudosteine on induced sputum cell components and lung function in patients with stable neutrophil-dominated COPD.METHODS:From October 2019 to October 2022,53 patients with stable COPD were selected and divided into fudosteine group and placebo group.The placebo group was treated with routine treatment,and the fudosteine group was treated with fudosteine on the basis of routine treatment.The two groups were treated for 6 months.The clinical symptoms[Saint George's Respiratory Questionnaire(SGRQ),COPD Assessment Test(CAT)and Modified British Medical Research Council Dyspnea scale(MMRC),Breathlessness,Cough,and Sputum Scale(BCSS)],lung function index,induced sputum cytology analysis and other related examination results were recorded in detail before and after treatment.RESULTS:(1)Compared with the baseline,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and the ratio of FEV1 to FVC(FEV1/FVC)of the two groups were improved after treatment,and the differences were statistically significant(P<0.05).However,after treatment,there was no significant difference in pulmonary function between the two groups except for the percentage of carbon monoxide diffusion in the predicted value(DLCO%pre)(DLCO%pre in the fudosteine group was higher than that in the placebo group).(2)After treatment,the total number of induced sputum cells and neutrophil counts in the fudosteine group were lower than those in the placebo group.Compared with the number of cells in each component at baseline,the total number of induced sputum cells and neutrophil count in the fudosteine group were significantly lower(P<0.05).CONCLUSION:Fudosteine treatment in patients with stable neutrophil-dominated COPD can improve lung function,reduce the total number of induced sputum cells and the total number of neutrophils,thereby improving airway inflammation.

关 键 词：慢性阻塞性肺疾病 诱导痰 肺功能 福多司坦 

分 类 号：R563[医药卫生—呼吸系统]