CAJ | 학술논문

目的探讨卡介菌多糖核酸(BCG-PSN)对哮喘患者外周血辅助性T细胞亚群及气道炎症的影响.方法 26例慢性持续期中度哮喘患者,分为单药组(氟替卡松和沙美特罗)13例、联合组(氟替卡松和沙美特罗+BCG-PSN)13例.观察治疗前、用药1.5个月和3个月后外周血辅助性T细胞亚群(Th1、Th2、Th3)及其血清细胞因子、IgE含量、诱导痰炎症细胞和临床疗效的变化.结果 (1)哮喘患者治疗1.5个月时2组比较:联合组与单药组Th1/Th2[(1.20±0.57)与(0.79±0.39),t=2.129,P＜0.05]、哮喘控制测试(ACT)[(18.31±1.75)与(15.54±2.40),t=3.359,P＜0.01]比较差异有统计学意义.治疗3个月时2组比较:联合组较单药组Th1/Th2[(1.73±0.74)与(1.16±0.48),t=2.327,P＜0.05]、ACT[(22.46±1.13)分与(20.23±2.59)分,t=2.851,P＜0.01]明显升高;呼气峰流速(PEF)日内变异率3个月时联合组较单药组明显降低[(9.88±2.18)%与(12.05±2.74)%,t=2.235,P＜0.05],差异亦有统计学意义.(2)外周血辅助性T细胞亚群及其血清细胞因子、IgE含量、诱导痰炎症细胞,2组间差异均无统计学意义(P均＞0.05);2组Th3细胞与IgE水平之间均无明显相关性.结论 BCG-PSN联合氟替卡松和沙美特罗能进一步纠正Th1/Th2失衡,减轻哮喘临床症状和气道高反应性,随治疗时间延长,疗效进一步提高,对哮喘患者外周血Th3细胞无显著影响.
목적 탐토잡개균다당핵산(BCG-PSN)대효천환자외주혈보조성T세포아군급기도염증적영향.방법 26례만성지속기중도효천환자,분위단약조(불체잡송화사미특라)13례、연합조(불체잡송화사미특라+BCG-PSN)13례.관찰치료전、용약1.5개월화3개월후외주혈보조성T세포아군(Th1、Th2、Th3)급기혈청세포인자、IgE함량、유도담염증세포화림상료효적변화.결과 (1)효천환자치료1.5개월시2조비교:연합조여단약조Th1/Th2[(1.20±0.57)여(0.79±0.39),t=2.129,P＜0.05]、효천공제측시(ACT)[(18.31±1.75)여(15.54±2.40),t=3.359,P＜0.01]비교차이유통계학의의.치료3개월시2조비교:연합조교단약조Th1/Th2[(1.73±0.74)여(1.16±0.48),t=2.327,P＜0.05]、ACT[(22.46±1.13)분여(20.23±2.59)분,t=2.851,P＜0.01]명현승고;호기봉류속(PEF)일내변이솔3개월시연합조교단약조명현강저[(9.88±2.18)%여(12.05±2.74)%,t=2.235,P＜0.05],차이역유통계학의의.(2)외주혈보조성T세포아군급기혈청세포인자、IgE함량、유도담염증세포,2조간차이균무통계학의의(P균＞0.05);2조Th3세포여IgE수평지간균무명현상관성.결론 BCG-PSN연합불체잡송화사미특라능진일보규정Th1/Th2실형,감경효천림상증상화기도고반응성,수치료시간연장,료효진일보제고,대효천환자외주혈Th3세포무현저영향.
Objective To explore the effect of BCG-polysaccharide nucleic acid(BCG-PSN) on the numbers of Th3,Th2 and Th1 cells in peripheral blood mononuclear cell(PBMC) and airway inflammation status in patients with asthma.Methods Twenty-six patients with moderate persistent asthma were enrolled into the study and randomly divided into simple medication group(n=13,accepted Fluticasone/salmeterol alone) and combined medication group(n=13,accepted Fluticasone/salmeterol+BCG-PSN together).The numbers of Th3,Th1 and Th2 cells in PBMC, the serum levels of TGF-β,IFN-γ,IL-4 and IgE and the clinical effect and airway inflammation status were observed at three time points: before,1.5 months after and 3 months after treatment. Results (1)At 1.5 months after treatment,the Th1/Th2 number was significantly higher in the combined medication group than the simple medication group(1.20±0.57 vs 0.79±0.39,t= 2.129,P＜0.05),and the asthma control test scale(ACT) showed similar difference(18.31±1.75 vs.15.54±2.40,t=3.359,P＜0.01) between the two groups.(2)At 3 months after treatment,the Th1/Th2 number was significantly higher in the combined medication group than the simple medication group(1.73±0.74 vs1.16±0.48,t=2.327,P＜0.05),and the ACT also showed the same kind of difference(22.46±1.13 vs.20.23±2.59,t=2.851,P＜0.01) between the two groups.In addition,at this time point the PEF variability was significant lower in the combined medication group than the simple medication group([9.88±2.18]% vs.[12.05±2.74]%,t=2.235,P＜0.05).(3)We found no significant differences in the comparisons of the numbers of T helper cell subsets in PBMC ,the serum levels of cytokines and IgE,the numbers of inflammatory cells in induced sputum between the two groups(Ps＞0.05).(4)No correlation were found between Th3 cell numbers in PBMC and the serum levels of IgE in the two groups.Conclusion The combined use of Fluticasone/salmeterol and BCG-PSN can further correct the imbalance of Th1/Th2 cells,alleviate clinical symptom of asthma and airway hyper-responsiveness.The therapeutic efficacy improves along with the therapy period,better in the combined medication group than the simple medication group.BCG-PSN has no significant effects on the numbers of Th3 in PBMC in patients with asthma.