摘要
目的观察度普利尤单抗治疗中重度哮喘(BA)的效果及对哮喘症状评分、肺功能的影响。方法选取2021年1月-2024年1月我院呼吸科收治的120例中重度BA患者为研究对象,根据入院顺序匹配随机数表打乱顺序进行随机分组,将其分为单抗组和对照组,各60例。对照组给予吸入激素(布地奈德)和长效β2受体激动剂(复方硫酸沙丁胺醇气雾剂)治疗,单抗组在常规治疗的基础上联合度普利尤单抗治疗。观察两组患者临床疗效,比较治疗前、治疗6个月后两组患者哮喘症状评分[哮喘控制评分(ACT)]、肺功能[呼出气一氧化氮(FeNO)、肺泡一氧化氮浓度(CaNO)、最大呼气峰流速(PEF)]、免疫相关因子指标[中性粒细胞与淋巴细胞比值(NLR)、白蛋白与球蛋白比值(AGR)]、血清炎症相关因子[嗜酸性粒细胞阳离子蛋白(ECP)、半胱氨酰白三烯(CysLTs)、尿白三烯E4(LTE4)]水平差异,记录治疗期间发生的不良反应。结果治疗6个月后,单抗组总有效率为96.67%,明显高于对照组80.00%(P<0.05);两组ACT评分均高于治疗前,且单抗组明显高于对照组(P<0.05);两组FeNO、CaNO低于治疗前,单抗组低于对照组;PEF指标高于治疗前,单抗组高于对照组(P<0.05);两组NLR、血清ECP、CysLTs、LTE4指标低于治疗前,且单抗组指标水平低于对照组;两组血清AGR指标高于治疗前,单抗组水平高于对照组(P<0.05);治疗期间,单抗组不良反应总发生率与对照组总发生率比较差异无统计学意义(P>0.05)。结论度普利尤单抗治疗中重度BA患者有利于减轻患者哮喘症状,减轻肺功能损伤,调节免疫平衡,安全性较高。
Objective To observe the effect of dupilumab in the treatment of moderate-to-severe bronchial asthma(BA)and its influence on asthma symptom score and lung function.Methods A total of 120 patients with moderate to severe BA admitted to the respiratory department of our hospital from January 2021 to January 2024 were selected as the research objects.According to the order of admission,a random number table was matched and the order was disrupted for random grouping.They were divided into the monoclonal antibody group and the control group,with 60 cases in each group.The control group was treated with inhaled hormones(budesonide)and long-acting β2 receptor agonists(compound salbutamol sulfate aerosol),while the monoclonal antibody group was treated with dupilumab in combination on the basis of conventional treatment.Observe the clinical efficacy of the two groups of patients The asthma symptom scores[Asthma Control Score(ACT)],lung functions[fractional exhaled nitric oxide(FeNO),alveolar nitric oxide concentration(CaNO),peak expiratory flow rate(PEF)],and immune-related factor indicators[neutrophil-to-lymphocyte ratio(NLR),albumin-to-globulin ratio]of the two groups of patients before treatment and 6 months after treatment were compared.The differences in the levels of serum inflammation-related factors[eosinophil cationic protein(ECP),cysteinyl leukotrienes(CysLTs),urinary leukotrienes E4(LTE4)]and the adverse reactions that occurred during the treatment were recorded.Results After 6 months of treatment,the total effective rate of the monoclonal antibody group was 96.67%,significantly higher than that of the control group(80.00%,P<0.05).The ACT scores of both groups were higher than those before treatment,and the monoclonal antibody group was significantly higher than the control group(P<0.05).The FeNO and CaNO levels in both groups were lower than those before treatment,and those in the monoclonal antibody group were lower than those in the control group.The PEF index was higher than that before treatment,and the monoclonal antibody group was higher than the control group(P<0.05).The indicators of NLR,serum ECP,CysLTs,and LTE4 in both groups were lower than those before treatment,and the indicator levels in the monoclonal antibody group were lower than those in the control group.The serum AGR indicators in both groups were higher than those before treatment,and the level in the monoclonal antibody group was higher than that in the control group(P<0.05).During the treatment period,there was no statistically significant difference in the total incidence of adverse reactions between the monoclonal antibody group and the control group(P>0.05).Conclusion Dupilumab in the treatment of patients with moderate to severe BA is beneficial to alleviate asthma symptoms,reduce lung function impairment,regulating immune balance,and has a relatively high safety.
作者
聂文朕
尹春燕
王欣雨
NIE Wenzhen;YIN Chunyan;WANG Xinyu(Department of Respiratory and Critical Care Medicine;Department of Pharmacy,Zigong First People′s Hospital,Zigong,Sichuan 643000,China;Department of Nephrology,Zigong Third People′s Hospital,Zigong,Sichuan 643000,China)
出处
《临床肺科杂志》
2025年第9期1359-1364,共6页
Journal of Clinical Pulmonary Medicine
基金
四川省医学科研项目(S19046)。
关键词
度普利尤单抗
中重度哮喘
疗效
哮喘症状评分
肺功能
Dupilumab
Moderate-to-severe asthma
Efficacy
Asthma symptom score
Lung function
