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目的:研究小剂量茶碱对哮喘气道炎症的作用。方法:19名哮喘患者用茶碱缓释剂(200mg,bid,平均血浆茶碱浓度7.9mg/L)治疗4周,分别用瑞氏染色、免疫组织化学及荧光免疫法检测治疗前后高渗盐水诱导痰中嗜酸细胞(Eos)、激活的Eos(EG2~(2+)Eos)和嗜酸细胞阳离子蛋白(ECP)的变化,并观察治疗前后症状积分和肺功能的变化。结果:用茶碱治疗前,患者痰中Eos、EG~(2+)Eos和ECP比健康人明显增加;用茶碱治疗4周后,哮喘患者诱导痰中Eos百分数下降(40％±17％ vs 29％±11％,P<0.01),EG~(2+)Eos百分数显著下降(28％±9％ vs 10 ％±8％,P<0.01),痰ECP明显下降[(373±206)vs(220±132)μg/L,P<0.01];症状明显好转(7.1±1.2 vs 5.4±1.6,P<0.01);肺功能明显改善,FEV_(1.0)增加(2.2±0.6 vs 2.4±0.5,P<0.01),FEV_(1.0)％也增加(60％±13％ vs 65％±13％,P<0.01)。结论:小剂量茶碱对哮喘气道炎症有明显抑制作用,同时使患者症状和肺功能明显改善。
Objective: To study the effect of low-dose theophylline on airway inflammation in asthma. Methods: Nineteen asthmatic patients were treated with theophylline sustained-release agent (200mg, bid, the average plasma theophylline concentration of 7.9mg / L) for 4 weeks. Wright’s stain, immunohistochemistry and fluorescence immunoassay The changes of eosinophils (Eos), activated Eos (EEG) and eosinophil cationic protein (ECP) in sputum were observed and the changes of symptom score and lung function were observed before and after treatment. Results: Before treatment with theophylline, the Eos, EG2 Eos and ECP in sputum were significantly higher than those in healthy volunteers. After 4 weeks of treatment with theophylline, the percentage of Eos in induced sputum of asthmatic patients decreased (40% ± 17% (29 ± 11%, P <0.01). The percentage of Eos in EG2 decreased significantly (28% ± 9% vs 10% ± 8%, P <0.01) (2.2 ± 0.6 vs 2.4 ± 0.5 vs (220 ± 132) μg / L, P <0.01]. The symptoms improved significantly (7.1 ± 1.2 vs 5.4 ± 1.6, P <0.01) , P <0.01), FEV_ (1.0)% also increased (60% ± 13% vs 65% ± 13%, P <0.01). Conclusion: The low-dose theophylline can significantly inhibit the airway inflammation in asthma, and at the same time, the symptoms and pulmonary function of the patients are significantly improved.