关键词: 支气管哮喘；辅助性T细胞亚群；细胞因子；气道炎症；氟替卡松；沙美特罗

Abstract:

Abstract:Objective  To explore the effects of fluticasone/salmeterol  on T helper cell(Th) subsets in peripheral blood  and airway inflammation in patients with asthma and provide a theoretical basis for their clinical application in treatment of asthma. Methods  13 patients with chronic persistent moderate asthma received  250　μg fluticasone/50 μg salmeterol inhalation （twice daily）　for 1.5 and 3.0 months. The changes of peripheral Th subsets and the levels of their cytokines and IgE in serum were detected，the inflammatory cells in induced sputum and the clinical effects in patients with asthma treated by fluticasone/salmeterol were observed.Results  Compared with before treatment,after treatment of  1.5 months  in patients with asthma：the percentage of Th3 was increased(P<0.05)，the percentage of  Th2 was decreased（P<0.05），the TGF-β and IL-4 had no significant change  in the peripheral blood（P>0.05）；the eosinophils(eos) in sputum was significantly decreased（P<0.01），the eos  in blood and neutrophils in sputum had no significant change；the PEF and ACT scores were  increased(P<0.01)，the PEF variability was decreased （P<0.01）， the use frequency of rescue medications for daily had no significant decrease； after treatment of  3.0 months:the Th1，Th1/Th2 and Th3 were increased，the Th2 was decreased（P<0.05 or P<0.01）；the IL-4 and TGF-β  were decreased(P<0.05)，the IFN-γ was increased （P<0.05）；the level of IgE had no significant change；the  eos in blood，eos  and neutrophils in sputum were decreased（P<0.01）；the PEF and ACT scores were  increased，the PEF variability was decreased （P<0.01），the use frequency of rescue medications for daily was decreased（P<0.01）；and the PEF variability was continuously decreased，the ACT were continuously increased （P<0.01）after treatment of  3.0 months compared after treatment of 1.5 months.Conclusion  Fluticasone/salmeterol can increase the numbers of  Th3 cells in peripheral blood of patients with asthma，correcte the imbalances of Th1/Th2 ratio ，reduce asthmatic airway inflammation and clinical symptoms in a time-dependent manner.

Key words: bronchial asthma； , T helper cell subsets；cytokine；airway inflammation； fluticasone;salmeterol