Objective To investigate the mechaniam and influence of budesonide and formoterol fumarate powder for rninhalation on airway remodeling and inflammatory mediators in bronchoalveolar lavage fluid( BALF) in patients with mild bronrnchial asthma( BA) . Methods Fifty-two patients with mild BA were randomly divided into three groups. Twenty-two patients in rnbudesonide and formoterol fumarate powder group( group A) were treated with budesonide and fonnoterol fumarate powder by rninhaling every night. Fifteen patients in budesonide group( group B) were treated with hudesonide by inhaling every night. Fifrnteen patients in conventional therapy group ( group C ) were treated with theophylline controlled release tablets 0. 2 g twice daily rnas well as ventolin aerosol 2 bell three times a day during asthmatic attack. Ten healthy subjects were selected as normal control rngroup( N group) . Before treatment and siX montha after treatment, mucosa biopsies of fiberoptic bronchoscopy was performed;rnThe thickneaa of bronchial mucosa's reticular hasement membrane( TRBM ) and the numbers of airway submucoaal myofibrornblasts were measured and compared;the levela of transforming growth factor-beta 1 ( TGF-β1 ) and matrix metalloproteinase-9 rn( MMP-9) were determined by enzyme-linked immunoaorbent assay. Results Before and after treatment, the number of cella rnin BALF,the number of eosinophilic granulocyte ( EOS) ,the level of TGF-β1, MMP-9 , TRBM and the number of airway subrnmucosal myofibroblaats in group A , B , and C were higher than those in N group aignificantly ( P ＜0. 01 ) . There was no obvioua rndifference in the indexe8 among grroup A, B and C( P ＞ 0. 05 ) . After treatment , the above indexes in group A and B were lower rnthan those in group C (P ＜0. 01) ,there was no obvioua difference in the number of BALF and EOS between group A and B rn(P＞0. 05) , but the level of TGF-β1 , MMP-9,TRBM and the number of airway submucosal myofibroblasts in group A were rnlower than those in group B ( P ＜0. 05). Conclusion Budesonide and formoterol fumarate powder for inhalation can relieve the airway remodeling hy inhihiting the airway inflammation.%目的 探讨布地奈德福莫特罗粉吸入剂吸入治疗对轻度支气管哮喘(BA)患者气道重塑和支气管肺泡灌洗液(BALF)中炎性介质的影响及其机制.方法 将52例轻度BA患者分为3组,布地奈德福莫特罗粉吸入剂组22例,每晚联合吸入布地奈德和福莫特罗;布地奈德组15例,每晚吸入布地奈德;常规治疗组15例,在哮喘发作期给予茶碱控释片0.2 g,每日2次,口服;沙丁胺醇气雾剂2揿,每日3次,吸入.另选健康受试者10名作为正常对照组.在治疗前和治疗6个月后分别经纤维支气管镜行支气管黏膜活检,测量并比较支气管黏膜网状基底膜厚度(TRBM)和黏膜下组织的肌纤维母细胞计数,酶联免疫吸附实验测定BALF中转化生长因子β1(TGF-β1)和基质金属蛋白酶-9(MMP-9)的水平.结果 布地奈德福莫特罗组、布地奈德组和常规治疗组治疗前后BALF中细胞总数、嗜酸性粒细胞(EOS)计数、TGF-β1和MMP-9含量、TRBM及黏膜肌纤维母细胞计数均显著高于正常对照组(P<0.01);治疗前布地奈德福莫特罗组、布地奈德组和常规治疗组上述指标比较差别均无统计学意义(P>0.05);治疗后布地奈德福莫特罗组和布地奈德组上述指标均低于常规治疗组(P<0.01),布地奈德福莫特罗组BALF中细胞总数和EOS计数与布地奈德组比较差别无统计学意义(P>0.05),而布地奈德福莫特罗组BALF中TGF-β1和MMP-9含量、TRBM和气道黏膜肌纤维母细胞计数均低于布地奈德组(P<0.05).结论 布地奈德福莫特罗粉吸入剂吸入治疗能显著减轻BA患者气道重塑,其机制可能与抑制气道炎症有关.
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