沙美特罗替卡松气雾剂对COPD稳定期疗效及Th17表达影响

摘要

Objective To observe curative effect of Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhala-tion in stable phase of chronic obstructive pulmonary disease ( COPD) and the impact on the expression of Th17 cells in the pe-ripheral serum. Methods 80 patients with definitely diagnosed COPD in stable phase during January 2011 to November 2012 were included in the study, and were randomly divided into the observation group (n=40) and the control group (n=40). At the end of the 2 years of follow-up, 7 patients discontinued Salmeterol Xinafoate medication and Fluticasone Propionate Powder for Inhalation and 4 cases lost follow-up in the control group as drop outs. Frequencies of acute exacerbations, pulmonary func-tion changes, changes in quality of life and the expressional changes of Th17 during the follow-up period of two groups were ob-served. Results (1) During the follow-up, the observation group had acute attack for (1. 8 ± 0. 3) times, the control group for (2. 4 ± 1. 9) times, and the differences showed statistical significance. (2)In the two groups with the first forced expiratory vol-ume (FEV1), FEV1/forced vital capacity (FVC), the quality of life SGRQ scores, percentage of CD4+IL-17+ T-cell, the differences before the treatment and after the treatment were statistically significant (P<0. 05), the downward tendency of the observation group was less than that of the control group (P<0. 05). The rise tendency of life quality SGRO scores was higher (P<0. 05). Conclusion Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation can slow down the progression of COPD, which may be associated with the down regulation of Th17 cell in the peripheral blood.%目的 观察沙美特罗替卡松气雾剂对慢性阻塞性肺疾病( chronic obstructive pulmonary disease, COPD)稳定期疗效及其对外周血Th17细胞表达的影响. 方法 选择2011年1月—2012年11月就诊并明确诊断的80例COPD稳定期患者,随机分为观察组40例和对照组40例. 随访观察2年研究结束时,观察组7例未坚持使用沙美特罗替卡松气雾剂,对照组4例失访,均作脱落处理. 观察两组随访期间COPD急性加重发作次数、肺功能、生活质量变化及Th17的表达情况. 结果 随访期间急性发作次数观察组(1. 8 ± 0. 3)次,对照组(2. 4 ± 1. 9)次,差异有统计学意义(P<0. 05). 两组第一秒用力呼气量(FEV1)、FEV1/肺活量(FVC)、生活质量SGRQ评分、CD4+IL-17+ T细胞百分率,治疗后与组内治疗前比较差异均有统计学意义(P<0. 05),且观察组下降趋势小于对照组(P<0. 05),生活质量SGRQ评分升高的趋势更明显(P<0. 05). 结论 沙美特罗替卡松气雾剂可减缓COPD病情进展,分析可能与下调外周血Th17细胞含量有关.