不同方案治疗良性支气管狭窄的临床疗效及对T淋巴细胞亚群及Th1/Th2平衡的影响

目的 研究球囊扩张术联合冷冻和球囊扩张术联合氩离子体凝固治疗良性支气管狭窄的临床疗效及对T淋巴细胞亚群及Th1/Th2平衡的影响.方法 选择120例良性支气管狭窄患者,随机分为A组和B组,每组60例,其中A组给予球囊扩张术+冷冻治疗.B组给予球囊扩张术+APC治疗,观察临床治疗效果及对T淋巴细胞亚群及Th1/Th2平衡的影响.结果 经支气管镜下治疗后2组支气管直径,FEV1和FVC水平较前明显升高,气促分级水平较前明显下降,与治疗前相比较差异均有统计学意义(P<0.05),其中A组治疗后支气管直径,FEV1和FVC水平高于B组,气促分级低于B组,差异均有统计学意义(P<0.05),A组经治疗后T淋巴亚群细胞水平变化差异无统计学意义(P>0.05),而B组CD3+,CD4+和CD4+/CD8+水平明显下降,而CD8+水平明显上升,与A组和治疗前比较,差异均有统计学意义(P<0.05),2组术后均出现Th1细胞减少、Th2细胞增加,Th1/Th2比值下降,其中A组与治疗前比较变化无明显的统计学意义(P>0.05),B组Th1细胞明显下降、Th2细胞增加,Th1/Th2比值下降,与A组和治疗前比较,差异均有统计学意义(P<0.05),2组均未发生严重的不良反应.结论 球囊扩张术联合冷冻治疗良性支气管狭窄的临床治疗效果优于球囊扩张术联合氩离子体凝固,可能与其对免疫功能影响较小等因素有关.

Therapeutic effects of two methods on benign bronchial stenosis and their effects on T lymphocyte subsets and balance of Th1/Th2

Objective To investigate the therapeutic effects of balloon dilatation combined with cryotherapy and balloon dilatation combined with argon plasma coagulation ( APC) on benign bronchial stenosis and their effects on T lymphocyte subsets and balance of Th1 /Th2.Methods One hundred and twenty patients with benign bronchial stenosis were randomly divided into two groups ,with 60 patients in each group.the patients in group A were treated by balloon dilatation +cryotherapy,however, the patients in group B were treated by balloon dilatation +APC.The therapeutic effects and their effects on T lymphocyte subsets as well as balance of Th 1/Th2 were observed and compared between two groups .Results After treatment,the bronchial diameter, levels of FEV1 and FVC in both groups were incaresed ,however, dyspnea grading was significantly decreased,as compared with those before treatment ( P <0.05).Moreover the bronchial diameter ,levels of FEV1 and FVC in group A were obviously higher than those in group B ,but the dyspnea grading in group A was significantly lower than that in group B ( P <0.05).After treatment, there were no significant differences in the changes of T lymphocyte subsets cellular levels in group A ( P >0.05), however,the levels of CD3+ ,CD4+ ,CD4+ /CD8+ in group B were significantly decreased,but the levels of CD8+ were obviously increased,as compared with those before treatment and those in group A (P <0.05).The decrease of Th1 cells,increase of Th2 cells and decrease of Th1 /Th2 ratio were found in both groups ,in which, there were no significant differences in these changes of group A ,as compared with those before treatment ( P >0.05), however,there were significant differences in these changes of group B ,as compared with those in before treatment and those in group A ( P <0.05).Besides no severe adverse reactions were observed in both groups .Conclusion The clinical effects of balloon dilatation combined with cryotherapy on benign bronchial stenosis are superior to those of balloon dilatation combined with argon plasma coagulation,which may be correlated to its less influences on immune function of patients .