Research On The Changes Of Micro Flora,Lysozyme And SIgA Levels In Sputum On Oropharynx In Bronchial Asthma Patients In Remission Period After Inhalation Of Glucocorticoid

PurposeThis study was designed to explore the effects of inhaled glucocorticoid on normal micro flora, Lysozyme and sIgA levels in sputum on oropharynx in bronchial asthma patients in remission period.MethodForty patients with bronchial asthma in remission period were chosen by random who had voluntarily received combined inhalation of Salmeterol/Fluticasone. Examinees stayed for clearance for2weeks before sampling and regularly inhaled Salmeterol/Fluticasone at50/250μg, twice a day. The experiment lasted for32weeks, follow-ups were taken in week2,8and32. Swab from posterior pharyngeal wall was used for bacterium cultivation. BioMerieux API system was used to qualitatively analyze the variety and quantity of pharynx flora. SpectraMax340PC Microplate Reader was used to test the concentration of Lysozyme and slgA in sputum. By comparing the results after the use of medicine and with the time going, determine changes of micro ecological indexes on the patients’ oropharynx (flora variety, flora diversity and dominant flora) and concentration of Lysozyme and sIgA. A control group was set up at the same time to compare with the asthma experimental group.Set a5%significance level,for measurements at different time points, statistical analysis use the method of analysis of variance and rank test.To explore and analyze the effects of combined inhalation of Salmeterol/Fluticasone on the patients’ oropharynx micro ecology and mucosa immunity.Result1. Streptococcus viridans and Neissiria were the main dominant flora of bronchial asthma oropharynx with a detection rate of100%. The detection rates of other five pathogenic flora (Enterococcus, Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Cray white Bacillus pneumonia) were relatively low or no. No fungus was detected from the asthma experimental group after treatment of combined inhalation of Salmeterol/Fluticasone follow-ups of week32.2. Comparison of the control group and the asthma group of dominant flora Strepyococcus viridans constituent ratio after treatment of combined inhalation of Salmeterol/Fluticasone showed that there was no statistical difference between follow-ups of week2and week8(P=0.78),there was statistical difference between follow-ups of week2and week32(P=0.002), there was statistical difference between follow-ups of week8and week32(P=0.001), there was statistical difference between follow-ups of week2,week8,week32by comparison with the control group of dominant flora Strepyococcus viridans constituent ratio separately (P<0.05). while there was no significant difference on distribution of dominant flora Neissiria genus constituent ratio on posterior pharyngeal wall of the asthma patients group between2,8and32weeks after treatment (P>0.05),but there was statistical difference between follow-ups of week2,week8,week32by comparison with the control group of dominant flora Neissiria genus constituent ratio separately (P<0.05). Comparison of the asthma group of measured concentration of lysozyme and sIgA in sputum after treatment with combined inhalation of Salmeterol/Fluticasone there was no statistical meaning as well (P>0.05)Conclusion1. Compared the treatment of combined inhalation of Salmeterol/Fluticasone at 50/250μg to bronchial asthma,the dominant bacteria on oropharynx was mainly streptococcus viridans and Neissiria genus in the respect of quantity, population and occupation. No fungus was detected from the asthma experimental group after treatment of combined inhalation of Salmeterol/Fluticasone follow-ups of32weeks.2. Present treatment of combined inhalation of Salmeterol/Fluticasone at50/250μg to bronchial asthma won’t cause ecological disorder to oropharynx micro flora, significant changes in proliferation and inhibition of oropharyngeal flora didn’t appear follow-ups of32weeks.3. With the extension of inhalation of Salmeterol/Fluticasone at50/250μg, concentration of Lysozyme and sIgA in sputum of bronchial asthma patients didn’t change with time of inhaled salmeterol/fluticasone obviously follow-ups of32weeks.