甘露醇联合妥布霉素吸入治疗囊性纤维化肺感染及对肺功能的影响  

Effect of mannitol combined with tobramycin inhalation on pulmonary infection in patients with cystic fibrosis and its effect on pulmonary function

作　　者：温晋青 徐镜萍 WEN Jinqing;XU Jingping(Department of Respiration,Cardiovascular and Cerebrovascular Diseases Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海省心脑血管病专科医院呼吸科,西宁810000

出　　处：《检验医学与临床》2018年第8期1115-1117,共3页Laboratory Medicine and Clinic

摘　　要：目的观察囊性纤维化(CF)铜绿假单胞菌肺感染患者雾化吸入妥布霉素和甘露醇的有效性和安全性。方法对照组(n=15)雾化吸入妥布霉素150mg,每天2次,观察组(n=21)在对照组基础上加用甘露醇200mg,每天2次。28d为1个疗程,2个疗程后观察呼吸功能指标肺活量(FVC)、第1秒用力呼气量(FEV1)、25%肺活量最大呼气量(MEF_(25))和50%肺活量位的最大呼气流量(MEF50)的变化,痰液铜绿假单胞菌最低抑菌浓度(MIC)变化。治疗期间观察记录两组不良反应。结果对照组治疗2个疗程后肺功能显著改善,观察组治疗1个疗程后肺功能显著改善,治疗后两组托管妥布霉素对铜绿假单胞菌MIC累积分布MIC50和MIC90均升高,但耐药菌发生率没有显著变化。观察组排痰性咳嗽和呼吸困难发生率均低于对照组。结论 CF合并PA感染,应用妥布霉素联合甘露醇雾化吸入治疗可显著改善呼吸系统症状和肺功能,且耐受性良好。Objective To observe the efficacy and safety of aerosol inhalation of tobramycin and mannitol in patients with cystic fibrosis(CF)infection with Pseudomonas aeruginosa(PA).Methods On the basis of conventional therapy,the control group(n=15)was inhaled with tobramycin 150 mg twice a day,the observation group was treated with tobramycin 150 mg and mannitol 200 mg,2 times/d.Respiratory function index vital capacity(FVC),first second forced expiratory volume(FEV1),maximum expiratory volume(MEF 25)and maximum expiratory volume of 50%lung function were measured after two courses of treatment.Changes in flow rate(MEF 50)were compared,minimal inhibitory concentration(MIC)of Pseudomonas aeruginosa in sputum were tested before and after treatment.Results The lung function was significantly improved in the control group after two courses of treatment,and the lung function was significantly improved after a course of treatment.The MIC distribution of MIC 50 and MIC 90 were increased in the two groups,but the incidence of drug-resistant bacteria did not change significantly.The incidence of expectoration cough and dyspnea in the observation group were significantly lower than those in the control group.Conclusion CF combined with PA infection,the application of tobramycin combined mannitol inhalation therapy can significantly improve respiratory symptoms and lung function,and well tolerated.

关 键 词：囊性纤维化 妥布霉素 甘露醇 肺感染 铜绿假单胞菌 

分 类 号：R563[医药卫生—呼吸系统]