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沙美特罗替卡松粉吸入剂联合胸腺五肽治疗COPD 患者的疗效及对血清IL-8、CTRP-4、CTRP-5的影响
方恩容,何杰,黄娜,邱静,代文静
0
(成都医学院第一附属医院呼吸内科)
摘要:
目的 探讨沙美特罗替卡松粉吸入剂联合胸腺五肽治疗慢性阻塞性肺疾病(COPD) 患者的疗效及对血清白介素8(IL-8)、补体C1q/肿瘤坏死因子相关蛋白(CTRP-4、CTRP-5)的影响。 方法 选择2015年10月~2017年10月我院就诊的92例COPD患者进行研究,通过随机数表法分为观察组(n=46)和对照组(n=46),对照组在常规治疗基础上给予沙美特罗替卡松粉吸入剂治疗,观察组在对照组基础上再联合胸腺五肽治疗,均连续治疗8周。比较两组临床疗效、治疗前后肺功能[第1 s用力呼出量(FEV1)、FEV1/用力肺活量(FVC)、最大呼气流量(PEF)]、免疫功能(T淋巴细胞亚群CD+3、CD+4、CD+4/ CD+8)及血清IL-8、CTRP-4、CTRP5的变化及药物不良反应。结果 治疗后,观察组总有效率明显高于对照组(P<0.05);两组治疗后,FEV1、FEV1/FVC、PEF均较治疗前升高(P<0.05),且观察组明显高于对照组(P<0.05);治疗后,两组CD+3、CD+4、CD+4/ CD+8较治疗前均升高(P<0.05),且观察组明显高于对照组(P<0.05);治疗后两组血清IL-8、CTRP-4、CTRP-5较治疗前均显著降低(P<0.05),且观察组明显低于对照组(P<0.05);两组治疗期间恶心呕吐、腹痛、头痛、食欲降低的总发生率比较,无显著差异(P>0.05)。结论 在COPD患者中使用沙美特罗替卡松粉吸入剂联合胸腺五肽效果显著,可降低血清IL-8、CTRP-4、CTRP-5的表达,改善免疫功能,促进肺功能恢复;联合用药并未增加药物不良反应,可在临床应用及推广。
关键词:  慢性阻塞性肺疾病  沙美特罗替卡松粉吸入剂  胸腺五肽  白介素 8  补体C1q/肿瘤坏死因子相关蛋白
DOI:
基金项目:四川省科技厅项目(2012JY0035)
Curative efficacy of salmeterol xinafoate and fluticasone propionate powder for inhalation combined with thymopentin in treatment of COPD and its effects on serum IL-8, CTRP-4, CTRP-5
FANG Enrong,HE Jie,HUANG Na,QIU Jing,DAI Wenjing
(Department of Respiratory Medicine, The First Affiliated Hospital of Chengdu Medical College)
Abstract:
Objective To study curative efficacy of salmeterol xinafoate and fluticasone propionate powder for inhalation combined with thymopentin in treatment of chronic obstructive pulmonary disease (COPD) and its effects on serum Interleukins (IL)8, complement C1q/tumor necrosis factor related protein (CTRP)-4, CTRP-5. Methods 92 patients of COPD received therapy from October 2015 to October 2017 in our hospital were selected as research objects. According to random number table,those patients were divided into the observation group (n=46) and the control group (n=46). On the basis of routine treatment, the control group was treated with salmeterol xinafoate and fluticasone propionate powder for inhalation, while the observation group was combined with thymopentin. They were treated continuously for 8 weeks. The clinical efficacy, the changes of pulmonary function[1 second forced expiratory volume (FEV1), FEV1/ forced vital capacity (FVC), maximum expiratory flow (PEF)], immune function (T lymphocyte subsets CD+3, CD+4, CD+4/ CD+8) and serum IL8, CTRP4 and CTRP5 before and after treatment between the two groups were compared. The adverse drug reactions were observed. Results After treatment, the total effective rate of clinical efficacy in the observation group was was significantly higher than that of the control group (P<0.05). After treatment, the FEV1, FEV1/FVC and PEF of two groups were significantly higher than those before treatment (P<0.05), and the FEV1, FEV1/FVC and PEF in the observation group were higher than those in the control group(P<0.05). After treatment, the CD+3, CD+4, CD+4/ CD+8 of two groups were significantly higher than those before treatment(P<005), and the CD+3, CD+4, CD+4/ CD+8 in the observation group were higher than those in the control group(P<0.05). After treatment, the serum IL-8, CTRP-4 and CTRP5 in the two groups were significantly lower than those before the treatment(P<0.05), and the serum IL-8, CTRP-4 and CTRP-5 in the observation group were lower than those in the control group(P<0.05). The total incidence of nausea and vomiting, abdominal pain, headache and loss of appetite during the treatment of the two groups was no significant difference(P>0.05). Conclusion Salmeterol xinafoate and fluticasone propionate powder for inhalation can reduce the expression of serum IL-8, CTRP-4 and CTRP-5, improve the immune function and promote the recovery of lung function.
Key words:  Chronic obstructive pulmonary disease  Salmeterol xinafoate and fluticasone propionate powder for inhalation  Thymopentin  Interleukins-8  Complement C1q/tumor necrosis factor related protein

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