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目的探讨胸腺肽α1对哮喘患者Th1/Th2调控的影响。方法采用临床随机对照研究的方法将50例轻、中度哮喘患者随机分成两组:基础治疗组(A组)25例,采用吸入糖皮质激素加β2激动剂治疗;实验组(B组)25例,在A组治疗方法基础上,加用胸腺肽α1(基泰)1.6mg皮下注射,一周2次,疗程12周。治疗前后分别测量血清中白细胞介素4(IL-4)、干扰素γ(IFN-γ)、白细胞介素12(IL-12)、白细胞介素13(IL-13)指标含量,并观察肺功能FEV1值及免疫球蛋白E(IgE)变化。另设健康对照组(C组)20例。结果A、B两组患者肺功能FEV1值治疗后较基线值分别提高0.27L和0.33L,白天哮喘症状评分分别减少0.78和0.74分,夜间哮喘症状评分分别减少1.02和1.13分,沙丁胺醇使用量分别减少1.84和1.72喷/日,两组之间比较均无显著性差异(P均>0.05)。A、B两组治疗前IL-4、IL-13、IgE水平均较健康对照组明显升高(P均<0.01),治疗后检测上述指标有明显下降(P<0.01),而IFN-γ、IL-12、IFN-γ/IL-4及IL-12/IL-13比值则与之相反。A、B两组之间对比,实验组治疗后IL-12水平及IL-12/IL-13比值高于基础治疗组(P均<0.05)。两组的不良反应轻微,两组之间无显著差异(P>0.05)。结论胸腺肽α1可以提高哮喘患者IL-12水平和IL-12/IL-13比值,在调节哮喘患者的Th1/Th2平衡方面有一定增强作用,在哮喘缓解期维持治疗和调节免疫上有应用价值。
Objective To investigate the effect of thymosin α1 on Th1 / Th2 regulation in asthmatic patients. Methods Fifty patients with mild to moderate asthma were randomly divided into two groups according to a randomized controlled clinical trial: 25 patients in the basic treatment group (group A) received glucocorticoid plus β2 agonist; and the other 25 patients in the experimental group (group B) Cases, in the A group based on the treatment, plus thymosin α1 (Kitai) 1.6mg subcutaneous injection twice a week for 12 weeks. Serum levels of IL-4, IFN-γ, IL-12 and IL-13 were measured before and after treatment. The levels of interleukin-6 Functional FEV1 values and immunoglobulin E (IgE) changes. Another set of healthy control group (C group) 20 cases. Results The pulmonary function FEV1 values in group A and group B were increased by 0.27L and 0.33L respectively after treatment, the scores of asthma symptom decreased by 0.78 and 0.74 respectively during the day, and the scores of night asthma symptom decreased by 1.02 and 1.13 respectively. Reduce 1.84 and 1.72 spray / day, no significant difference between the two groups (P> 0.05). The levels of IL-4, IL-13 and IgE in groups A and B before treatment were significantly higher than those in healthy controls (all P <0.01), and the levels of IFN-γ , The ratio of IL-12, IFN-γ / IL-4 and IL-12 / IL-13 was the opposite. The levels of IL-12 and IL-12 / IL-13 in the experimental group were higher than those in the basic treatment group (P <0.05). Adverse reactions were mild in both groups, with no significant difference between the two groups (P> 0.05). Conclusions Thymosin α1 can increase the level of IL-12 and IL-12 / IL-13 in asthmatic patients, enhance the balance of Th1 / Th2 in asthmatic patients, and have therapeutic value in maintenance therapy and immune regulation during asthma remission.