小剂量罗红霉素对小气道疾病患者血清中三种细胞因子的影响

小气道疾病(SAD)是慢性阻塞性肺疾病(COPD)的早期病理过程,有多种细胞因子参与,目前无确切的干预方法,本课题研究SAD细胞因子的变化及小剂量罗红霉素对SAD各种细胞因子的影响。首先研究健康查体确诊的SAD患者及非SAD患者的细胞因子的变化;其次对161例支原体抗体阴性的SAD患者,随机分为罗红霉素治疗组81例、对照组80例进行研究。治疗组口服小剂量罗红霉素0.15/d,3个月,对照组未予任何治疗,治疗开始前、治疗后1、3、6、12个月测定细胞因子TNF-α、TGF-β1、IL-8的变化,同时检查肺功能。结果SAD组患者TNF-α、TGF-β1、IL-8明显高于非SAD组,两组差异显著(P<0.05);治疗组SAD随着时间的延长TNF-α、TGF-β1、IL-8逐渐下降,肺功能逐渐好转,相关性分析,肺功能与细胞因子的变化成明显负相关(P<0.05),1年后统计治疗组SAD治愈率50%,对照组10%,两者差异显著,治疗组SAD发生率低因此,小剂量罗红霉素可有效抑制SAD细胞因子TNF-α、TGF-β1、IL-8的生成,抑制气道的慢性非特异性炎症,减少SADCOPD的发生。

Influences of small doses of Rexithromycin on the production of cytokines in small airway disease

Small airway disease (SAD) is the early pathogenic course of chronic obstructive pulmonary disease (COPD) with involvement of a variety of cytokines participating in the course of disease. To investigate the influences of Rexithromycin on the production of various eytokines in the course of this disease, 81 cases of SAD patients with negative mycoplasma antibodies and 80 cases of normal control were randomly selected for study, in which 0.15 g per day of Rexithromycin was orally administrated in the treated group, and no drug was given in the control group. The changes of the levels of cytokines, such as TNF-α, TGF-β and IL-8 were examined before treatment and 1, 3. 6 and 12 months after treatment with simultaneous examinations of pulmonary functions. It was found that there was significant difference in the levels of TNF-α, TGF-β and IL-8 between the SAD patients and the control group. In the treated group, the levels of cytokines gradually dropped and the pulmonary functions became better as prolongation of the therapy time. By correlation analysis, it was demonstrated that negative correlation existed between changes of cytokine levels and pulmonary functions(P<0.05). The recovery rate of SAD patients increased as the therapy went on, and the cure rate after one year treatment with small dose of Rexithromycin was 50% in comparison of 10% in the control group. The incidence of SAD in the treated group was low. It is concluded that treatment with small dose of Rexithromycin can effectively inhibit the productions of TNF-α, TGF-β and IL-8, thereby to minimize the chronic non-specific inflammations in the airway, so as to reduce the incidences of SAD and COPD.