不同疗程吸入布地奈德对咳嗽变异性哮喘的影响

目的探讨不同疗程吸入布地奈德对咳嗽变异性哮喘（CVA）患者气道炎症、气道高反应性（AHR）的影响，为CVA的治疗提供理论依据。方法40例CVA患者随机分为A、B两组，每组20例，另设正常对照组（N组）。A、B两组均予吸入布地奈德200μg，2次／d，A组吸入疗程为8周，B组吸入疗程为半年；记录A、B两组咳嗽症状缓解时间，比较3组治疗前后诱导痰嗜酸性粒细胞比值（EOS％）、肺功能及AHR的差异。结果A、B两组患者经治疗后咳嗽症状多于4～8周左右完全缓解。A、B两组治疗前诱导痰EOS％高于N组（P〈0．05）；A、B两组治疗前均存在AHR，但肺功能与N组无明显差异（P〉0．05）；A组治疗后诱导痰EOS％下降（P〈0．05）．AHR无明显改善（P〉0．05），A组治疗后肺功能与治疗前相比差异无统计学意义（P〉0．05）；B组治疗后诱导痰EOS％降至正常、AHR较前降低，与治疗前比较，差异均有统计学意义（P〈0．05），B组治疗后肺功能与治疗前相比差异无统计学意义（P〉0．05）。B组治疗后诱导痰EOS％、AHR与A组治疗后相比明显下降，差异有统计学意义（P〈0．05）。结论CVA患者经吸入皮质激素治疗后咳嗽症状可在较短时间内缓解，但其病理生理改变仍在持续．长疗程吸入激素治疗更有利于改善CVA的气道炎症及AHR。

Influence of inhaled Budesonide with different course of treatment to cough variant asthma

Objective To explore the Influence of inhaled Budesonide with different course of treatment to the airway inflammation and airway hyperresponsiveness（AHR） of cough variant asthma（CVA）. Methods Forty patients with CVA were divided into group A （20 cases）and group B （20 cases）, 20 normal subjects were recruited as healthy group（group N） in this study. Both group A and group B inhaled Budesonide for 200 μg, twice a day. The course of treatment of group A was 8 weeks, and that of group B was half year. The relieved time of cough symptom was recorded. The change of eosinophil（EOS） proportion in induced-sputum, lung function and AHR of the three groups before and after treatment were compared. Results The EOS proportion of CVA groups （group A and group B） before treatment were higher than group N （P 〈 0.05）. Lung function parameters were not different between CVA group and group N, CVA group auhad AHR. The EOS proportion of group A decreased after treatment（P 〈 0.05）, but there was no improvement in AHR after treatment（P 〉 0.05）,the lung function parameters of group A before and after treatment were not different （P 〉 0.05）. The EOS proportion of B group turned normal after treatment （P 〈 0.05）, and AHR of group B after treatment decreased （P 〈 0.05）, the lung function parameters of group B before and after treatment had no difference （P 〉 0.05）. Compared with group A after treatment, the EOS proportion and AHR of group B after treatment decreased significantly（P 〈 0.05）.Conclusion Cough symptom of CVA patients could relieve in short time by inhaled corticosteroids, but the change of pathophysiology was still persistent. Long course of treatment with inhaled corticosteroids was better to improve airway inflammation and AHR.