李剑 佟金平 苗姝

【摘要】 目的：探討瑞舒伐他汀对支气管哮喘患者气道炎症、肺功能及病情控制的影响。方法：选取2019年1-12月于大连大学附属新华医院呼吸内科就诊的支气管哮喘患者60例，按照随机数字表法分为治疗组和对照组，各30例。对照组患者给予沙美特罗替卡松粉吸入剂治疗，治疗组患者在对照组的基础上给予瑞舒伐他汀钙片治疗。治疗前和治疗12周后，比较两组血清中IL-4、IL-5、IL-13及IL-17水平;比较两组的第一秒用力呼气容积占预计值百分比（FEV1%pred）、呼气峰流速占预计值百分比（PEF%pred）和哮喘控制测试（ACT）评分。结果：治疗12周后，两组患者血清中IL-4、IL-5、IL-13及IL-17水平均较治疗前明显降低，差异均有统计学意义（P<0.05）;且治疗组患者治疗后各项指标均较对照组降低更加明显，差异均有统计学意义（P<0.05）。治疗12周后，两组患者FEV1%pred、PEF%pred、ACT评分均较治疗前显著升高，差异均有统计学意义（P<0.05）;且治疗组患者治疗后各项指标均较对照组升高更加显著，差异均有统计学意义（P<0.05）。结论：瑞舒伐他汀可通过纠正Th1/Th2免疫失衡，抑制Th17细胞分化，减少IL-17的分泌而发挥免疫调节作用，且增强糖皮质激素的抗炎作用，从而减轻哮喘气道炎症，改善肺功能，提高哮喘临床控制水平，为哮喘治疗提供新方向。

【关键词】 支气管哮喘 瑞舒伐他汀 气道炎症 肺功能

[Abstract] Objective： To explore the impact of Rosuvastatin on airway inflammation， pulmonary function and disease control of patients with bronchial asthma. Method： From January 2019 to December 2019， 60 patients with bronchial asthma were selected in the department of respiratory， Affiliated Xinhua Hospital of Dalian University. According to the expression of random numbers， they were divided into treatment group and control group， 30 cases in each group. The patients in the control group were given Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation， the patients in the treatment group were given Rosuvastatin Calcium Tablets on the basis of the control group. Before and after 12 weeks of interventions， serum levels of IL-4， IL-5， IL-13 and IL-17 were compared between the two groups; the percentages of forced expiratory volume in the first second （FEV1%pred）， peak expiratory flow in the first second （PEF%pred）， and asthma control test （ACT） scores were compared between the two groups. Result： After 12 weeks of treatments， the serum levels of IL-4， IL-5， IL-13 and IL-17 were significantly decreased in both groups， the differences were statistically significant （P<0.05）; above indicators in the treatment group after treatment were significantly lower than those in the control group （P<0.05）. After 12 weeks of treatments， FEV1%pred， PEF%pred and ACT scores were significantly increased in both groups， the differences were statistically significant （P<0.05）; above indicators in the treatment group after treatment were significantly higher than those in the control group （P<0.05）. Conclusion： Rosuvastatin can exert immune regulation through correcting the imbalance of Th1/Th2， restraining Th17 cell differentiation， decreasing the level of IL-17， and enhance anti-inflammatory effect of glucocorticoids， thereby can relieve the airway inflammation， improve pulmonary function， raise the level of asthma control， and provide a new direction for asthma treatment.

[Key words] Bronchial asthma Rosuvastatin Airway inflammation Pulmonary function First-authors address： Affiliated Xinhua Hospital of Dalian University， Dalian 116021， China

支气管哮喘（bronchial asthma）简称哮喘，是一种临床上常见的慢性呼吸系统疾病，近年来其患病率逐年上升。据统计，全球至少有3亿哮喘患者，每年至少有250 000例患者因哮喘死亡[1];2013年中国哮喘联盟发布，我国约有3 000万哮喘患者，每年医疗费用约为900亿元人民币[2]。随着GINA指南知识在临床上的广泛推广与普及，吸入糖皮质激素和长效β2受体激动剂联合使用极大地提高了哮喘的临床控制水平，然而哮喘的急诊就诊率和死亡率却未见显著降低[3]。因此，有关新型哮喘治疗药物仍然是亟待研究的热点。哮喘是由多种细胞和细胞组分参与的气道慢性炎症性疾病，其发病机制与Th1/Th2免疫失衡以及Th17细胞功能亢进密切相关[4-6]。他汀类药物是目前临床上最常用的降血脂药，但最近研究发现它还具有抗炎作用和免疫调节作用，对多种疾病治疗有益。……