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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。
Objective: To observe the effects of low dose roxithromycin on airway hyperresponsiveness in patients with bronchial asthma. Methods: 48 cases of bronchial asthma patients were randomly divided into observation group (22 cases) and control group (26 cases). Two groups of patients were given inhalation of budesonide suspension 0.25 mg, bid; inhalation of salbutamol sulfate solution 200μg, bid; aminophylline 0.25g added 5% glucose injection 250ml intravenous infusion, bid. After 3 days of continuous use, aminophylline was discontinued in the control group according to the improvement of symptoms. The dosage of budesonide suspension and salbutamol sulfate solution was adjusted as needed. The patients in the observation group were discontinued aminophylline, Su-100 mg, bid. Two groups of patients were treated for 15 days. The FEV1, FEV1%, PEF, IL-2, IL-4 and IL-5 levels in the two groups before and after treatment were observed. IFN-γ, Th1, Th2, Th1 / Th2 and adverse reactions. Results: There was no significant difference in pulmonary function index, inflammatory factor level, Th1, Th2, Th1 / Th2 between the two groups before treatment (P> 0.05). IL-2, INF-γ, Th1 and Th1 / Th2 were significantly higher in the two groups after treatment than those in the control group, and the levels of IL-4, IL-5 and Th2 in the observation group were significantly higher than those in the control group Significantly lower than the same group before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). CONCLUSION: Low dose roxithromycin can improve pulmonary ventilation in patients with bronchial asthma and relieve airway hyperresponsiveness with good safety.