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目的:探讨乌司他丁治疗支气管哮喘的临床研究及血清白介素(IL)-2、IL-4、T细胞亚群的变化。方法:选择2014年1月至2016年10月我院接诊的98例支气管哮喘患者,通过随机数表法分为观察组(n=49)和对照组(n=49)。对照组使用常规治疗,包括抗炎、改善通气、纠正酸碱平衡紊乱、雾化吸入糖皮质激素及β2受体激动剂、补充电解质等,观察组联合乌司他丁治疗,均连续治疗7 d。比较两组临床疗效、临床症状消退时间,并于治疗前后采集3 mL空腹静脉血,使用流式细胞仪检测血清IL-2、IL-4、T细胞亚群的变化。结果:治疗后,观察组临床疗效总有效率明显高于对照组(P<0.05);观察组呼吸困难、哮鸣音、胸闷、咳嗽症状消退时间明显比对照组短(P<0.05);治疗前,两组血清IL-2、IL-4比较差异不明显(P>0.05),和治疗前比较,两组治疗后血清IL-2、IL-4均得到显著改善(P<0.05),观察组血清IL-2明显高于对照组,血清IL-4明显比对照组低(P<0.05);T细胞亚群中,两组治疗前CD3~+、CD4~+、CD8~+、CD4~+/CD8~+比较无显著差异(P>0.05),治疗后,两组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+水平较治疗前均显著改善(P<0.05),观察组CD3~+、CD4~+、CD4~+/CD8~+均比明显对照组高,CD8~+明显低于对照组(P<0.05)。结论:在支气管哮喘患者中应用乌司他丁效果显著,可有效缓解临床症状,改善血清IL-2、IL-4及T细胞亚群的表达,调节机体免疫功能,临床应用价值高。
Objective: To investigate the clinical research of ulinastatin in bronchial asthma and the changes of serum interleukin (IL) -2, IL-4 and T cell subsets. Methods: A total of 98 patients with bronchial asthma admitted to our hospital from January 2014 to October 2016 were randomly divided into observation group (n = 49) and control group (n = 49). The control group received routine treatment, including anti-inflammatory, improving ventilation, correcting the acid-base balance disorders, atomizing inhalation of glucocorticoid and β2 receptor agonists, electrolyte supplementation, the observation group combined with ulinastatin, were treated for 7 days . The clinical curative effect and clinical symptom subsidence time were compared between the two groups. Before and after treatment, 3 mL fasting venous blood was collected. The changes of the serum IL-2, IL-4 and T cell subsets were detected by flow cytometry. Results: After treatment, the total effective rate of observation group was significantly higher than that of control group (P <0.05). The observation group had shorter dyspnea, wheeze, chest tightness and cough symptoms than the control group (P <0.05) Before and after treatment, the levels of IL-2 and IL-4 in serum of the two groups were not significantly different (P> 0.05). Compared with those before treatment, the levels of IL-2 and IL-4 in both groups were significantly improved Serum levels of IL-2 in serum were significantly lower than those in the control group (P <0.05). Serum levels of IL-4 were significantly lower in the T cell subsets than those in the control group (P <0.05). The levels of CD3 +, CD4 +, CD8 + (P <0.05). After treatment, the levels of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + in both groups were significantly improved (P <0.05) ), CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + in the observation group were significantly higher than those in the control group and CD8 ~ + was significantly lower than that in the control group (P <0.05). Conclusion: The application of ulinastatin in patients with bronchial asthma significantly improves the clinical symptoms, improves the expression of serum IL-2, IL-4 and T cell subsets, and modulates the immune function of the patients with high clinical value.