Comparison of the effects of different doses of prednisone combined with voriconazole on lung function and IgE levels in patients with allergic bronchopulmonary aspergillosis / 中国基层医药

ABSTRACT

Objective:To compare the effects of different doses of prednisone combined with voriconazole on lung function and IgE levels in patients with allergic bronchopulmonary aspergillosis.Methods:From January 2018 to December 2018, 100 patients with allergic bronchopulmonary aspergillosis who admitted to Shaoxing Central Hospital were selected in this research.The patients were divided into two groups by the random number table method, with 50 cases in each group.The control group received high-dose prednisone combined with voriconazole, while the observation group received low-dose prednisone combined with voriconazole.The clinical effects after treatment were compared, including forced vital capacity (FVC), forced expiratory volume at the first second (FEV 1), FEV 1/FVC, peripheral blood eosinophilia (EOS), IgE, tumor necrosis factor alpha (TNF-α ), interleukin-6 (IL-6), interleukin-8 (IL-8) and adverse reactions. Results:After treatment, the total effective rate of the observation group was 94.00%(47/50), which was higher than 68.00%(34/50) in the control group (χ 2=10.981, P<0.05). Before treatment, the FVC, FEV 1, FEV 1/FVC between the two groups showed no statistically significant differences (all P>0.05). After treatment, the FVC, FEV 1, FEV 1/FVC of the observation group [(3.29±0.21)L, (1.86±0.25)L, (73.81±5.16)%] were higher than those of the control group [(2.61±0.21)L, (1.58±0.28)L, (65.85±5.07)%], the differences were statistically significant( t=16.190, 5.274, 7.781, all P<0.05). Before treatment, the EOS and IgE levels in peripheral blood showed no statistically significant differences between the two groups (all P>0.05). After treatment, the peripheral blood levels of EOS and IgE [(0.21±0.11)×10 9/L, (187.36±37.12)U/mL] in the observation group were lower than those in the control group [(0.34±0.14)×10 9/L, (689.35±40.16)U/mL], the differences were statistically significant ( t=5.163, 64.907, all P<0.05). Before treatment, the levels of TNF-α, IL-6 and IL-8 showed no statistically significant differences between the two groups (all P>0.05). After treatment, the levels of TNF-α, IL-6 and IL-8 of the observation group [(13.59±5.14)pg/L, (6.15±3.01)ng/L, (276.25±87.51)ng/L] were lower than those of the control group [(19.48±5.01)pg/L, (10.25±3.52)ng/L, (322.27±99.74)ng/L], the differences were statistically significant ( t=5.802, 6.259, 2.452, all P<0.05). The overall incidence of adverse reactions in the observation group was 6.00%(3/50), which was lower than 26.00%(13/50) in the control group (χ 2=7.441, P<0.05). Conclusion:Low-dose prednisone combined with voriconazole in the treatment of patients with allergic bronchopulmonary aspergillus has significant effect, which can effectively improve the pulmonary function and IgE level of patients, and reduce adverse reactions.