A Study On The Reactive Relationship Between Sputum Eosinophils And Methylprednisolone Therapy For The Patients With Acute Attack Of Asthma

Objective: this thesis aims to explore the influence of Methylprednisolone therapyon sputum eosinophils, and the clinical value of alleviating asthma symptoms.Methods:80cases of patients with bronchial asthma, male or female, age between30and70are chosen to randomly form a40-person hormone therapy group and a40-person not hormone therapy group.40cases of healthy people, male20, female20,age between25and65are chosen as a healthy control group. Selection criteria: allpatients suffer from acute attack of asthma and their Eos surpass3%before therapy.Besides, they have a clear history of asthma over a year. What’s more, their bronchialdiastolic test is positive which needs to use hormone therapy with intravenous drip. Allthese conform to the diagnosis criteria of asthma in prevention and treatment of bronchialasthma guidelines established by The Chinese medical association respiratory neurology,asthma group in2008. Sputum sample collection and processing: inducing sputumcytology classification and counting with reference to the method recommended by theChinese medical association respiratory neurology. Pulmonary function test: BDTPositive diagnostic criteria: after therapy, FEV1increases12%or more and Increases theabsolute value200ml or more. All patients should not have the smoking history, and amonth before the test all patients did not receive glucocorticoids (GCS) or immunemodulators and they also have no respiratory infections. All patients are given salbutamolaerosol inhalation100μg per time, doxofylline intravenous drip0.3g per time. Accordingto pathogenic condition, the author decides whether to adopt antibiotic therapy andcorrect acid-base imbalance, electrolyte disorder and treat other basic disease. At the same time, the patients in hormone therapy group are given intravenous drip MP40mg/dfor seven days. Statistical method: all data are counted and analyzed through the softwareSPSS17.0. Measurement data is shown in the form of mean+/-standard deviation andthe data comparison adopts the analysis of variance and rank sum test. Enumeration dataadopts chi-square test. The difference has statistically significance (P<0.05).Results:1、Before therapy, the comparison of clinic and sputum Eos numberbetween asthma groups and the healthy group: there is no statistical significance aboutthe comparison of age, gender, and sex ratio between asthma groups and healthgroup(P>0.05). Compared with the healthy group, sputum Eos number of each asthmagroup obviously increases(P<0.01), and FEV1、PEF、FEV1%and FEV1/FVC%allobviously reduce(P<0.01). Before the treatment, there is no statistical significance aboutthe comparison of sputum number of Eos、FEV1、PEF、FEV1and FVC/FEV1%inhormone treatment group and not hormone treatment group patients (P>0.05).2、After seven-day therapy, the comparison of clinic and sputum Eos numberbetween asthma groups and the healthy group: sputum Eos number in asthma obviouslyreduces(P<0.01), and FEV1、PEF、FEV1%and FVC%obviously increase(P<0.01).Besides, ACQ score increases significantly (P<0.01). The comparison between hormonetherapy group and not hormone therapy group: after therapy, FEV1、PEF、FEV1%andFEV1/FVC%、the number of sputum Eos and ACQ score changes have significantdifference (P<0.05). Eos number of these two asthma groups both significantly higherthan that of the healthy control group (P<0.05), but the Eos number of hormone therapygroup is much closer to that of the control group.3、The Eos number of patients with acute attack of asthma is negatively relatedwith FEV1%(r=﹣0.481, P<0.05), negatively related with FEV1/FVC%(r=﹣0.436,P<0.05), and positively related with ACQ score (r=0.318, P<0.01).Conclusion: After seven-day Methylprednisolone therapy on the patients inhormone therapy group, the Eos%significantly reduces, however, there is no obviouschange for each index of the patients in not hormone therapy group, which caters to the previous study that methylprednisolone can inhibit the synthesis and release of Eos.Besides, this thesis also discovers that in the acute onset of asthma patients, Eos%significantly increases, which is negatively related with FEV1%、FEV1/FVC%. Themeasurement of FEV1%、FEV1/FVC%can objectively reflect asthma patients’ lungfunction condition. We can also know that Phlegm Eos, as a kind of inflammatory cells,is closely related to asthma severity. The significant difference through the comparisonbetween asthma groups and control group can also well support our point of view. In themethylprednisolone treatment on patients with acute attack of asthma, Eos can beconsidered as an effective index to evaluate curative effect and adjust the therapy plan.