摘要
目的:探讨乌司他丁对慢性阻塞性肺疾病(COPD)合并免疫功能降低患者调节性T细胞(Treg)、辅助性T细胞17(Th17)的调节作用.方法:选择2014年3月—2017年4月我院收治的142例COPD合并免疫功能降低患者,按随机数字表法分为对照组与观察组,各71例,对照组给予COPD基础对症处理,观察组在对照组基础上加用注射用乌司他丁(10万U+0.9% 氯化钠注射液100 mL,ivgtt,bid)治疗,比较两组治疗效果,监测治疗前后患者肺功能、Treg、Th17细胞的变化及免疫相关因子[白介素(IL)-6、IL-10、IL-17、转化生长因子(TGF)-β]水平的变化,统计治疗不良反应发生率.结果:①观察组治疗总有效率为90.14%,高于对照组的77.46%,差异有统计学意义(P<0.05);②治疗前,两组肺功能指标、Th17、Treg细胞水平及Th17/Treg比值比较差异无统计学意义(P>0.05),治疗后,观察组1秒用力呼吸容积(FEV1)、用力肺活量(FVC)、1秒用力呼吸容积占用力肺活量百分比(FEV1/FVC)、Treg细胞水平高于对照组,Th17细胞水平及Th17/Treg比值低于对照组,差异有统计学意义(P<0.05);③治疗后观察组IL-6、IL-17、TGF-β 水平低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05);④两组不良反应发生率比较差异无统计学意义(P>0.05).结论:乌司他丁治疗COPD合并免疫功能低下患者的疗效肯定,可调节Th17/Treg平衡,改善患者肺功能.
Objective:To investigate the regulatory effect of ulinastatin on regulatory T cells(Tregs)and helper T cells 17(Th17)in patients with chronic obstructive pulmonary disease(COPD)and decreased immunity.Methods:142 patients with COPD and decreased immunity admitted to our hospital from March 2014 to April 2017 were selected and randomly into a control group and an observation group,71 cases each.The patients in the control group were given COPD basic symptomatic treatment,and the patients in the observation group were further treated with ulinastatin for injection(100,000 U+0.9%sodium chloride injection 100 mL,ivgtt,bid).The therapeutic effect was compared between the two groups.The changes in pulmonary functions,Treg and Th17 cells and the levels of immunity-related factors[interleukin(IL)-6,IL-10,IL-17 and transforming growth factor(TGF)-β]before and after treatment were monitored,and the incidence of adverse reactions was statistically analyzed.Results:The total effective rate in the observation group was 90.14%,which was higher than 77.46%in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the levels of lung function indexes,Th17 and Treg cells and the ratio of Th17/Treg between the two groups(P>0.05).After treatment,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)and the level of Treg cells in the observation group were higher than those in the control group,and the level of Th17 cells and the ratio of Th17/Treg were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the levels of IL-17 and TGF-βin the observation group were lower than those in the control group,while the level of IL-10 was higher than that in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ulinastatin is effective in the treatment of the patients with low COPD and decreased immunity,which can regulate Th17/Treg balance and improve the lung functions of the patients.
作者
江万仓
Jiang Wan-cang(RICU,Sanmenxia Central Hospital,Sanmenxia Henan 472000,China)
出处
《中国合理用药探索》
CAS
2019年第6期178-182,共5页
Chinese Journal of Rational Drug Use
作者简介
江万仓,男,副主任医师。研究方向:呼吸与危重症。E-mail:jetzyw8782@163.com
