Research On The Changes Of Micro Flora, SIgA And Lysozyme Levels In Sputum On Pharynx In Airflow Limitation Pulmonary Diseases Patients After Combined Inhalation Of Salmeterol And Fluticasone

Objective : This study was designed to explore the effects of inhaled Salmeterol/Fluticasone on normal micro flora, Lysozyme and sIgA levels in sputum on pharynx in airflow limitation pulmonary diseases patients.Method: Sixty-eight patients with asthma or COPD in remission period were chosen by random who had voluntarily received combined inhalation of Salmeterol/Fluticasone. Examinees stayed for clearance for 2 weeks before sampling and regularly inhaled Salmeterol /Fluticasone at 50/250μg, twice a day. The experiment lasted for 32 weeks, follow-ups were taken in week 2, 8 and 32. Swab from pharynx was used for bacterium cultivation. BioMerieux API system was used to qualitatively analyze the variety and quantity of pharynx flora. SpectraMax 340PC Microplate Reader was used to test the concentration of Lysozyme and sIgA in sputum. By comparing the results before and after the use of medicine and with the time going, determine changes of micro ecological indexes on the patients’ pharynx(flora variety, flora diversity and dominant flora) and concentration of Lysozyme and sIgA. To explore and analyze the effects of combining inhalation of ICS-LABA on the patients’ respiratory micro-ecology and mucosa immunity .Result : Airflow limitation pulmonary diseases patients,with COPD and asthma non-acute patients as the representative,received combined inhalation of Salmeterol/Fluticasone treatment 2,8 and 32 weeks , the detection rate of dominant flora viridansstreptococcusafter the treatment of 2 weeks compared to 8 weeks changes -0.82±0.34, and compared to 32 weeks changes -12.95±2.32, the two were significantly different (t = 4.046, P <0.001 ). The change rate of the genus Neisseria was 3.97±1.82 compared with the group at 2 weeks after treatment changes9.66±2.65,and the difference was significant (t =1.469, P = 0.144). (T = -2.285, P = 0.024),and the variation range was 0.08±0.02 at 32 weeks after treatment, and the difference was significant (t =-2.285, P =0.024). Saliva SIgA concentration after 2 weeks of treatment compared to 8 weeks changes 2.39±0.89, 2 weeks after treatment compared to 32 weeks changes 6.40±1.00, the result is diffrent (t =-3.000, P =0.003). Lysozyme changes 50.97±16.48 for 2 weeks after treatment, and -22.02±11.31 for 32 weeks after treatment. There was a significant difference between the two groups (t=3.653, P<0.001).Conclusion: Combined with inhalation of salmeterol / fluticasone for 32 weeks of airflow limitation pulmonary diseases in patients with oropharyngeal micro-basic maintenance of steady state, the number of species diversity did not change significantly, and promote the beneficial advantages of Streptococcus viridans growth.Saliva SIgA levels continued to decline,the level of lysozyme fluctuations,oropharyngeal local mucosal immunity by a certain impact, but the overall oropharyngeal mucosal health.