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目的探讨激素敏感型哮喘患者(SSA)与激素抵抗型哮喘患者(SRA)经甲基强的松龙(MP)治疗前后外周血中白细胞介素-4(IL-4)表达水平的变化及意义。方法给予反复发作的13例SSA患者和6例SRA患者MP 40 mg治疗1周,采用ELISA法检测患者治疗前后的血清IL-4水平并进行比较。结果经治疗后SSA患者组血清IL-4水平较SRA患者组显著降低(P<0.01)。结论①SSA患者组治疗前后血清IL-4浓度的明显变化,提示糖皮质激素的抗炎作用可能部分是通过降低血清IL-4浓度实现的。②SRA患者组治疗前后血清IL-4浓度较SSA患者组无明显变化,提示治疗前后血清IL-4浓度变化可以作为观察患者是否存在激素抵抗的一个指标,可能是激素抵抗形成的原因之一。
Objective To investigate the changes and significance of interleukin-4 (IL-4) in peripheral blood of patients with steroid-sensitive asthma (SSA) and hormone-resistant asthma (SRA) before and after treatment with methylprednisolone (MP) . Methods Thirteen patients with SSA and six patients with SRA were treated with MP 40 mg for 1 week. Serum IL-4 level before and after treatment was detected by ELISA and compared. Results After treatment, the level of serum IL-4 in SSA patients was significantly lower than that in SRA patients (P <0.01). Conclusions ① The significant change of serum IL-4 level in patients with SAH before and after treatment suggests that the anti-inflammatory effect of glucocorticoid may be partly through the reduction of serum IL-4 concentration. Serum IL-4 levels in patients with SRA before and after treatment showed no significant changes compared with those in patients with SSA, suggesting that changes of serum IL-4 levels before and after treatment may be used as an index to observe whether there is hormone resistance in patients with SAH, which may be one of the reasons for the formation of hormone resistance.