小剂量罗红霉素对支气管哮喘患者气道高反应性的影响

目的:观察小剂量罗红霉素对支气管哮喘患者气道高反应性的影响。方法:48例支气管哮喘患者按随机数字表法分为观察组(22例)和对照组(26例)。两组患者均给予吸入用布地奈德混悬液0.25 mg,bid;吸入用硫酸沙丁胺醇溶液200μg,bid;氨茶碱0.25 g加入5%葡萄糖注射液250 ml中静脉滴注,bid。连用3 d后,根据症状改善情况,对照组患者停用氨茶碱,并按需要调整布地奈德混悬液和硫酸沙丁胺醇溶液的剂量;观察组患者停用氨茶碱,加服罗红霉素100 mg,bid。两组患者疗程均为15 d。观察两组患者治疗前后第1秒用力呼气量(FEV1)、FEV1占预计值的百分率(FEV1%)、最大呼气流速(PEF)、白介素(IL)-2、IL-4、IL-5、干扰素(INF)-γ、1型辅助T细胞(Th1)、2型辅助T细胞(Th2)、Th1/Th2及不良反应发生情况。结果:治疗前两组患者肺功能指标、炎性因子水平、Th1、Th2、Th1/Th2比较,差异均无统计学意义(P>0.05)。治疗后两组患者肺功能指标、IL-2、INF-γ、Th1、Th1/Th2均显著高于同组治疗前,且观察组显著高于对照组;IL-4、IL-5、Th2均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:小剂量罗红霉素能改善支气管哮喘患者肺通气功能,缓解气道高反应性,且安全性较好。

Effects of Small Dose of Roxithromycin on Airway Hyperreactivity in Patients with Bronchial Asthma

OBJECTIVE： To observe the effects of small-dose roxithromycin on airway hyperreactivity in patients with bronchial asthma. METHODS： 48 patients with bronchial asthma were randomly divided into observation group （22 cases） and control group （26 cases）. 2 groups inhaled Budesonide suspension 0.25 mg, bid; inhaled Albuterol sulfate solution 200μg, bid; aminophylline 0.25 g added into 5% Glucose injection 250 ml intravenously, bid, for consecutive 3 day. According to the improvement of symptoms, control group stopped taking aminophylline and adjusted the dose of Budesonide suspension and Albuterol sulfate solution; observation group stopped taking aminophylline and additionally received roxithromycin 100 mg, bid. Treatment course of 2 groups lasted for 15 d. FEV1, FEVI%, PEF, IL-2, IL-4, IL-5, INF-γ, Th1, Th2, Th1/Th2 and ADR were observed in 2 groups before and after treatment. RESULTS： There was no statistical significance in lung function index, the levels of inflammatory cyto- kines, Thl, Th2, Thl/Th2 between 2 groups before treatment （P〉0.05）. After treatment, lung function index, IL-2, INF-γ, Thl and Thl/Th2 of 2 groups after treatment were significantly higher than before; those of observation group were higher that control group signifincantly. IL-4, IL-5 and Th2 of 2 groups after treatment were significantly lower than before; those of observation group was lower than control group signifincantly; there was statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Small-dose of roxithromycin can improve lung function and relieve airway hyperreactivity in patients with bronchial asthma with good safety.