老年慢性阻塞性肺疾病患者肺结核感染的临床诊治  

Clinical diagnosis and treatment of pulmonary tuberculosis infections in elderly patients with chronic obstructive pulmonary disease

作　　者：刘俊[1] 王丹华[2] 喻成波[3] 张秋芬[1] 叶玲玲[1] 

机构地区：[1]浙江省磐安县人民医院内二科,浙江磐安县322399 [2]浙江省磐安县人民医院内一科,浙江磐安县322399 [3]浙江大学医学院附属第一医院感染科,浙江杭州310003

出　　处：《中华医院感染学杂志》2015年第21期4917-4919,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技厅计划基金资助项目(201426)

摘　　要：目的探讨盐酸氨溴索与异烟肼雾化给药方式对老年慢性阻塞性肺疾病合并肺结核感染的临床疗效。方法随机选取2013年10月-2014年12月老年慢性阻塞性肺疾病患者肺结核感染100例,将其分为观察组和对照组各50例,对照组采用常规抗结核抗感染综合治疗,观察组在传统常规抗结核、抗感染的基础上,采用盐酸氨溴索与异烟肼雾化给药方式治疗,记录并对比两组患者临床疗效、机体免疫系统T淋巴细胞亚群指标变化和细胞因子变化。结果两组患者治疗6个月后治疗有效率观察组为88.0%、对照组为70.0%,两组比较差异有统计学意义(χ2=4.88,P<0.05);观察组患者的CD4+、CD4+/CD8+比值及IL-1、TNF-α的含量均高于对照组患者,而CD8+及sIL-2R含量均低于对照组患者,两组比较差异均有统计学意义(P<0.05)。结论采用盐酸氨溴索与异烟肼雾化给药方式进行抗结核抗感染的综合治疗,能提高老年慢性阻塞性肺疾病合并肺结核感染治疗的临床疗效。OBJECTIVE To observe the clinical effect of ambroxol hydrochloride and isoniazid atomization for drug administration on treatment of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis infections.METHODS A total of 100 elderly patients with chronic obstructive pulmonary diseases complicated with pulmonary tuberculosis infections who were treated from Oct 2013 to Dec 2014 were randomly enrolled in the study and divided into the observation group and the control group,with 50 cases in each.The control group was treated with conventional anti-tuberculosis and anti-infection therapy,while the observation group was given additional ambroxol hydrochloride and isoniazid atomization for drug administration on the basis of the conventional anti-tuberculosis and anti-infection therapy.The clinical effects,changes of indicators of body immunity system T-lymphocyte subsets,and changes of cytokines were recorded and compared between the two groups.RESULTS The effective rate of treatment of the observation group was 88.0% after the treatment for 6months,the control group 70.0%,with significant difference（χ^2=4.88,P〈0.05）.The rate of CD4^＋of the observation group was higher than that of the control group;the ratio of CD4^＋to CD8^＋of the observation group was higher than that of the control group;the contents of IL-1 and TNF-αof the observation group were higher than those of the control group;however,the contents of CD8^＋and sIL-2Rof the observation group were lower than those of the control group,with significant difference（P〈0.05）.CONCLUSION The use of ambroxol hydrochloride and isoniazid atomization for the anti-tuberculosis and anti-infection comprehensive treatment can improve the clinical effect on treatment of the elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis infections.

关 键 词：慢性阻塞性肺疾病 肺结核感染 老年患者 

分 类 号：R563.1[医药卫生—呼吸系统]