丙酸倍氯米松联合孟鲁司特钠对咳嗽变异性哮喘患者气道炎症控制及外周血IgG 4、ICAM-1水平影响-现代医学

丙酸倍氯米松联合孟鲁司特钠对咳嗽变异性哮喘患者气道炎症控制及外周血IgG 4、ICAM-1水平影响

单位：1. 川北医学院临床医学院, 四川南充 637000;
2. 广元市中心医院呼吸内科, 四川广元 628000

关键词：咳嗽变异性哮喘丙酸倍氯米松孟鲁司特钠外周血免疫球蛋白4 细胞间黏附分子-1

分类号：R562.2+5

出版年·卷·期（页码）：2019·47·第二期（153-157）

摘要：

目的：观察丙酸倍氯米松雾化吸入联合孟鲁司特钠对咳嗽变异性哮喘（CVA）患者气道炎症控制及外周血免疫球蛋白4（IgG 4）及细胞间黏附分子-1（ICAM-1）水平影响。方法：采用便利抽样的方法，纳入120例CVA患者为调查对象，按照数字表法将其随机分成对照组和研究组，每组60例。对照组仅给予吸入丙酸倍氯米松混悬液进行治疗，研究组在对照组治疗基础上加用孟鲁司特钠进行治疗，两组均连续治疗12周，比较研究组和对照组中患者治疗成功率和复发率，并分析两组患者治疗前后血清白细胞介素（IL-5、IL-8和IL-10）、外周血免疫球蛋白4（IgG 4）、细胞间黏附分子-1（ICAM-1）水平以及肺功能支气管舒张试验的变化情况。结果：研究组哮喘控制率优于对照组（75.00%/50.00%），差异有统计学意义（χ²=4.658，P=0.031）；治疗后，研究组患者IL-5、IL-8、IL-10和TNF-α的水平明显低于对照组（P<0.05）；治疗后研究组血清IgG 4水平高于对照组，ICAM-1水平低于对照组，差异均有统计学意义（P<0.05）；治疗后随访3个月，对照组复发11例（18.33%），研究组复发2例（3.33%），两组比较差异有统计学意义（χ²=6.988，P=0.008）。结论：丙酸氟替卡松通过与孟鲁司特钠的联合作用，对于治疗咳嗽变异性哮喘效果显著，有效降低炎症因子及ICAM-1水平，并且对提高IgG 4水平也有很大疗效，值得推广和应用。

Objective:To observe the effect of beclomethasone dipropionate combined with montelukast on airway inflammation control and peripheral blood IgG 4 and ICAM-1 levels in patients with cough variant asthma.Methods:120 patients with cough variant asthma were enrolled in the study by convenient sampling. The subjects were divided into control group and study group with 60 cases in each group by random number table method. The control group was treated with beclomethasone dipropionate, and the study group was treated with montelukast sodium based on the control group, The patients in the two groups were treated continuously for 12 weeks. The success rate and relapse rate of patients in the study group and the experimental group were compared, and the levels of serum interleukin (IL-5,IL-8) and interleukin (IL-10) were analyzed before and after treatment. Changes of peripheral blood immunoglobulin 4 (IgG 4), intercellular adhesion molecule-1 (ICAM-1) and bronchodiastolic test.Results:The control rate of asthma in the study group was better than that in the control group (75.00% vs 50.00%), and the difference was statistically significant (χ²/4.658%, P<0.031). After treatment, the levels of IL-5,IL-8,IL-10 and TNF-α in the study group were significantly lower than those in the control group (P<0. 05). After treatment, the serum IgG 4 level and ICAM-1 level in the study group were higher than those in the control group, respectively (P<0.01). After 3 months follow-up, 11 cases (18.33%) recurred in the control group and 2 cases (3.33%) in the study group. The difference between the two groups was statistically significant (χ², 6.98 8, P<0.008).Conclusion:Fluticasone propionate combined with montelukast sodium is effective in the treatment of cough variant asthma and can effectively reduce the levels of inflammatory factors and ICAM-1. It also has a great effect on raising the level of IgG 4. It is worth popularizing and applying.

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