摘要
目的观察长期小剂量罗红霉素对支气管扩张症稳定期患者诱导痰白介素6(IL-6)、IL-8和IL-10水平的影响及临床疗效。方法将2013年1月至2015年10月该院收治的60例支气管扩张症稳定期患者分为治疗组和对照组,每组60例。治疗组口服小剂量罗红霉素(每次0.15 g,每天1次,治疗6个月),对照组未服用抗菌药物。观察两组患者治疗前、治疗6个月后临床症状评分、急性加重次数、肺功能指标[用力1秒呼气量(FEV1)、用力肺活量(FVC)]变化等。采用酶联免疫吸附试验测定两组患者诱导痰IL-6、IL-8和IL-10水平,高倍光学显微镜分析诱导痰中的中性粒细胞百分比。结果治疗组患者治疗6个月后临床症状评分,诱导痰中的中性粒细胞百分比、IL-6、IL-8水平均明显低于治疗前,且明显低于对照组治疗后;IL-10水平明显高于治疗前,且明显高于对照组治疗后,差异均有统计学意义(P<0.05);急性加重次数明显少于对照组,差异均有统计学意义(P<0.05);两组患者FEV1及FVC均无明显改善。诱导痰中的中性粒细胞百分比与IL-6、IL-8水平呈正相关(r=0.216、0.284,P<0.05),与IL-10水平呈负相关(r=-0.421,P<0.05)。结论长期口服小剂量罗红霉素可调节支气管扩张症患者诱导痰IL-6、IL-8和IL-10水平,抑制气道高炎性反应,进而改善患者症状,减少急性加重次数。
ObjectiveTo study the effects of long-term low-dose treatment with roxithromycin on IL-6,IL-8and IL-10in induced sputum in patients with bronchiectasis in stable period.MethodsSixty patients with clinically stable bronchiectasis,who were received in the hospital from January2013to October2015,were divided into the control group and the treatment group,30cases in each group.The treatment group were administrated with low-dose oral roxithromycin capsule(0.15g/d)for6months,while the control group was without antibiotics.The clinical symptoms,exacerbation frequency,and pulmonary function parameters[the forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)]in both groups were observed in both groups after6-month treament.The concentrations of IL-6,IL-8and IL-10in induced sputum of patients in both groups were measured by enzyme-linked immunosorbent assays,and neutrophil ratio in induced sputum were analyzed by a high-power optic microscope.ResultsAfter6-month treatment,the clinical symptom score,neutrophil ratio in induced sputum,and the levels of IL-6,IL-8in the treatment group decreased obviously than that before treatment,with statistically significant difference(P<0.05)the level of IL-10increased obviously than that before treatment,the exacerbation frequency was remarkably lower than that in the control group,with statistically significant difference(P<0.05).There was no obvious improvement on FEV1and FVC in both group after6-month treatment.The neutrophil ratio was positively correlated with IL-6and IL-8(r=0.216、0.284,P<0.05),but negatively with IL-10(r=-0.421,P<0.05).ConclusionLong-term low-dose oral treatment with roxithromycin can regulate the levels of IL-6,IL-8and IL-10in patients with bronchiectasis in stable period,inhibit high inflammatory response in airway,improve clinical symptoms and reduce exacerbation frequency.
作者
陈畅
曹伟云
廖周旭
Chen Chang;Cao Weiyun;Liao Zhouxu(Department of Respiratory Medicine,the First Affiliated Hospital of Hunan Traditional Chinese Medical College,Zhuzhou,Hunan 412000,China)
出处
《现代医药卫生》
2017年第22期3385-3388,共4页
Journal of Modern Medicine & Health
基金
湖南省卫生和计划生育委员会科研基金项目(B2014080)
