| Objective:1. From aspects of asthma control test (ACT)score, high resolution computed tomography (HRCT), pulmonary function and pathological discussing comprehensivly drug intervention influence on asthma control.2. To comprehensivly explore the change of airway remodeling before and after treatment in asthma from asthma control test score, imaging,function and biomarkers.Methods:1. Forty-eight patients with asthma were enrolled from the first hospital of Shanxi medical university period June to December2008.These patients were examined high-re solution computer tomography(HRCT) images,pulmonary function and induced sputum before treatment.2. They were standard treatment one year according to the Global Initiative for Asthma(GINA)2003,again follow-up visiting,making use of ACT questionnaire assessing clinical controlling situation, who were reexamine like the above, sputum smear counting eosinophil the percentage of white blood cells(EOS%) and determining concentration of matrix metalloproteinase-9(MMP-9), tissue-inhibitor metalloproteinase (TIMP-1) and transforming growth factor-β1(TGF-β1) with enzyme linked immunosorbent assay (ELASA) of sputum.3. HRCT was taken with64rows GE spire CT. The percentage airway wall area (WA%),airway wall thickness to airway diameter (2T/D) were calculated and the lung tissue density in inspiratory and expiratory phase were measured on HRCT images.Result:1. After normative treatment being intervened by drug for one year,there were34patients continuing to enter the experiment group,they were assessed by ACT,Achieving complete controlling15cases, portion controlling12cases, uncontrolling7cases.2. From HRCT images,finding the2T/D and WA%in patients with asthma were statistically significant (P<0.05) and decreased comparing with before treatment; there were no statistical significance between before with after treatment about lung tissue density in inspiratory or expiratory phase(P>0.05),but the difference between inspiratory phase and expiratory phase had statistical significance between before with after treatment(P<0.05).3. Level of MMP-9, TIMP-1and TGF-β1on sputum were also were statistically significant (bothp<0.05) and decreased after treatment.4. The2T/D,WA%of patients after treatment are correlated positivly with the expression levels of MMP-9,TIMP-1,MMP-9/TIMP-1and TGF-β1of sputum,while these index are correlated n e ga tiv e ly wit h the p e rcen t a ge fo rc ed e xpi r a t or y vo lum e in th e fir st se c o n d (F EV1%)、the ra tio o ffor c e d exp irat o ry vo lu me in th e fir st se c o nd a nd fo rc e d vit a l c a p a c it y (FE V1/FV C%), th ep e rce nt a ge for ce d vit a l c apa cit y (FV C%) o f p u lmo na r y fu n c tio n a n d EO S%are co rrela tedn e ga tiv e ly wit h FE V1%、 F EV1/FV C%o f p u lmo na r y fu nc tio n.Co nc l us ion s:1. HR C T, AC T, p ulmo na ry fun c tio n a nd sp ut u m ca n b e u se d to co mpr eh e ns iv ly evalua ted e g ree o f a s th ma c o nt rol in ath ma tic p a tie n ts.2. Drug in te r ve n tio n tre a tme n t co ul d ma ke a irw ay w a ll th ick ne ss, g as re te nt io n, p u lmo na r yfun ctio n o f the a s th ma pa tie n ts b e imp r o v e d, a nd the inf la mma tor y cy to ki n e s d e c rease d, the reb yp rev en te d the re p e a ted a tta c ks o f a sthm a an d th e fo r ma t ion o f irr eve rs ib le airflo w o bs tr u c tio n. |
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