孙　洋　闵冬雨

1.沈阳市第十人民医院重症医学科，辽宁沈阳110044；2.辽宁中医药大学附属医院，辽宁沈阳　110032

沙美特罗替卡松粉吸入剂联合硫酸沙丁胺醇对支气管哮喘患者血清IL-6、TNF-α和IL-4、IFN-γ及Th1/Th2免疫平衡影响研究

孙洋1闵冬雨2▲

1.沈阳市第十人民医院重症医学科，辽宁沈阳110044；2.辽宁中医药大学附属医院，辽宁沈阳110032

目的观察沙美特罗替卡松粉吸入剂联合硫酸沙丁胺醇对支气管哮喘患者血清IL-6、TNF-α和IL-4、IFN-γ 及Th1/Th2免疫平衡影响。方法选取2014年10月～2015年10月于我院住院治疗支气管哮喘患者60例作为治疗组，同时选取我院健康检查患者30例作为对照组，治疗组给予沙美特罗替卡松粉联合硫酸沙丁胺醇雾化吸入治疗，分别与治疗前，治疗1个月、2个月、3个月时抽取患者晨起静脉血，分离血清，Elisa法检测患者血清IL-6、TNF-α和IL-4、IFN-γ水平。结果与治疗前和对照组比较，沙美特罗替卡松粉吸入剂联合硫酸沙丁胺醇应用治疗支气管哮喘3个月后，患者血清IL-6、TNF-α和IL-4水平显著降低（P＜0.05），IFN-γ水平显著升高（P＜0.05），免疫调节明显向Th1方向调节（P＜0.05）。结论沙美特罗替卡松粉吸入剂与硫酸沙丁胺醇联合应用治疗支气管哮喘患者，可能通过调节患者体内IL-6、TNF-α、IL-4、IFN-γ与炎症相关的细胞因子及Th1/Th2免疫平衡实现。

沙美特罗替卡松粉吸入剂；硫酸沙丁胺醇；支气管哮喘；IL-6；TNF-α；Th1/Th2

［Abstract］Objective To observe the influence on the combination of Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation and salbutamol sulfate on bronchial asthma patients serum IL-6，TNF-α，IL-4，IFN-γand Th1/ Th2 cytokine imbalance.Methods A total of 60 patients of bronchial asthma treated in our hospital from October 2014 to October 2015 were selected as the treatment group.At the same time，selected 30 people under our hospital's health examination as the control group.The treatment group was received the therapy of the combination of Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation and salbutamol sulfate.The treatment group venous blood were taken in themorning，using themethod of isolating serum，Elisa detection on IL-6，TNF-α，IL-4 and IFN-γ，before the treatment，after 1 month，after 2 months，after 3months.Results Compared with the control group and the treatment group before therapy，under the combination of Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation and salbutamol sulfate therapy，after 3months therapy，the bronchial asthma serum of IL-6，TNF-αand IL-4 levels were significantly decreased，while the IFN-γlevel increased（P＜0.05）.The immunoregulation is obviously trend to Th1 direction（P＜0.05）.Conclusion The combined application of salmeterol xinafoate and fluticasone propionate Powder for Inhalation and salbutamol sulfate on the bronchial asthma patients，probably be achieved by regulating the IL-6，TNF-α，IL-4，IFN-γ，cytokines related on inflammation and Th1/Th2 immune balance.

［Key words］Salmeterol xinafoate and fluticasone propionate Powder for inhalation；Salbutamol sulfate；Bronchial asthma；IL-6；TNF-α；Th1/Th2

支气管哮喘是临床常见疾病，本病反复发作，较难治愈，严重影响人们生活质量，目前对于支气管哮喘的发病机制研究尚不明确，认为本病是树突状细胞、嗜酸性粒细胞、T淋巴细胞、细胞因子等免疫学因素，遗传学因素和神经调节机制等有着密切关系［1］。……