2017 年第 12 期 第 12 卷

雾化吸入布地奈德联合口服泼尼松治疗嗜酸细胞性支气管炎的临床效果

作者：王馨平吴昭萍李光清亓占中

英文作者：

单位：610011成都，解放军第四五二医院呼吸内科

英文单位：

关键词：嗜酸细胞性支气管炎；布地奈德；泼尼松

英文关键词：

• 摘要：

• 目的    探究雾化吸入布地奈德与口服泼尼松联合用药用于治疗嗜酸细胞性支气管炎（EB）的临床效果。方法    回顾性分析2012年3月至2015年12月解放军第四五二医院收治的115例确诊为EB患者的病历资料。以2012年3月至2013年10月收治的33例患者为对照组，以2013年11月至2015年12月收治的82例患者为观察组。对照组采用雾化吸入布地奈德和沙丁胺醇治疗；观察组采用雾化吸入布地奈德联合口服泼尼松治疗；2组均持续治疗7 d。比较2组治疗前后的免疫功能指标［免疫球蛋白E（IgE）、CD+4、CD+8、CD+4/CD+8］和病情相关指标［白细胞介素5（IL-5）、呼出气体一氧化氮、诱导痰嗜酸粒细胞阳离子蛋白（ECP）］。治疗后6个月比较2组临床疗效和复发情况，以及治疗后的SF-36生活质量评分。结果    治疗后2组IgE、CD+4、CD+8、CD+4/CD+8较治疗前明显改善，且观察组治疗后各指标均明显优于对照组［（0.11±0.05）g/L比（0.24±0.18）g/L、（43.5±3.6）%比（36.7±3.5）%、（30.4±3.9）%比（36.7±5.1）%、（1.31±0.20）比（0.89±0.36）］（均P＜0.05）。治疗后2组IL-5、呼出气体一氧化氮、ECP较治疗前明显降低，且观察组治疗后各指标均明显低于对照组［（0.038±0.015）μg/L比（0.212±0.175）μg/L、（20±5）ppb比（33±5）ppb、（26±6）μg/L比（43±10）μg/L］（均P＜0.05）。观察组疗效明显优于对照组（Z＝33.209，P＜0.05），6个月复发率明显低于对照组［4.9%（4/82）比42.4%（14/33）］（P＜0.05）。观察组治疗后SF-36量表中生理功能、情感功能、社会功能得分均明显高于对照组［（87±3）分比（66±8）分、（91±10）分比（71±5）分、（77±4）分比（51±7）分］（均P＜0.05）。结论    雾化吸入布地奈德联合口服泼尼松治疗EB较原雾化吸入布地奈德联合沙丁胺醇疗法的效果更佳。

• Clinical effect of budesonide inhalation combined with oral prednisone on eosinophilic bronchitis

  Wang Xinping, Wu Zhaoping, Li Guangqing, Qi Zhanzhong

  Department of Respiratory Medicine, No.452 Hospital of the Chinese People′s Liberation Army, Chengdu 610011, China

  Corresponding author: Wang Xinping, Email: wnxinp@163.com

  【Abstract】Objective    To investigate the clinical effect of budesonide inhalation combined with oral prednisone on eosinophilic bronchitis（EB）. Methods    Clinical data of 115 EB patients from March 2012 to December 2015 in No.452 Hospital of the Chinese People′s Liberation Army were retrospectively analyzed. Patients who were admitted from March 2012 to October 2013 had budesonide and salbutamol inhalation（control group）; patients who were admitted from November 2013 to December 2015 had budesonide inhalation combined with taking prednisone tablets（observation group）; the course of treatment was 7 d. Changes of immune function indexes［immunoglobulin E（IgE）, CD+4, CD+8, CD+4/CD+8］ and disease evaluation indexes［interleukin-5（IL-5）, exhaled nitric oxide, eosinophil cationic protein（ECP）］ were recorded. Clinical efficacy, relapse and quality of life were analyzed 6 months after treatment. Results    After treatment, IgE, CD+4, CD+8 and CD+4/CD+8 were significantly improved and there were significant differences between observation group and control group［（0.11±0.05）g/L vs （0.24±0.18）g/L, （43.5±3.6）% vs （36.7±3.5）%, （30.4±3.9）% vs （36.7±5.1）%, （1.31±0.20） vs （0.89±0.36）］（P＜0.05）. IL-5, exhaled nitric oxide and ECP significantly decreased after treatment in both groups; the indexes in observation group were significantly lower than those in control group［（0.038±0.015）μg/L vs （0.212±0.175）μg/L, （20±5）ppb vs （33±5）ppb, （26±6）μg/L vs （43±10）μg/L］（P＜0.05）. Clinical efficacy in observation group was significantly better than that in control group（Z＝33.209, P＜0.05）. The 6-month relapse rate in observation group was significantly lower than that in control group［4.9%（4/82） vs 42.4%（14/33）］（P＜0.05）. Scores of physiological function, emotive function and social function in the SF-36 in observation group were significantly higher than those in control group［（87±3）points vs （66±8）points, （91±10）points vs （71±5）points, （77±4）points vs （51±7）points］（P＜0.05）. Conclusion    Budesonide inhalation combined with oral prednisone treating EB is more effective than budesonide and salbutamol inhalation.

  【Key words】Eosinophilic bronchitis;Budesonide;Prednisone