甲泼尼龙联合布地奈德雾化吸入对AECOPD患者炎性因子及免疫功能的影响  

Effects of methylprednisolone combined with budesonide inhalation on inflammatory factors and immune function in patients with acute exacerbation of COPD

作　　者：朱彦秋 代福恒 侯海龙 苗晓亮 车京爱 Zhu Yanqiu;Dai Fuheng;Hou Hailong;Miao Xiaoliang;Che Jingai(Department of Respiratory and Critical Care Medicine,Second Clinical Medical College of Jilin Medical College/Meihekou Central Hospital,Meihekou 135000,China)

机构地区：[1]吉林医药学院第二临床医学院/梅河口市中心医院呼吸与危重症医学科

出　　处：《疑难病杂志》2020年第2期122-126,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：中国宋庆龄基金会呼吸疾病临床研究公益基金(2018MZFC-014)~~

摘　　要：目的观察甲泼尼龙联合布地奈德雾化吸入对急性加重期慢性阻塞性肺疾病(AECOPD)患者炎性因子及外周血白细胞CD64和CD11b指数的影响。方法选择2017年7月-2019年5月吉林医药学院第二临床医学院/梅河口市中心医院呼吸与危重症医学科收治AECOPD患者96例作为研究对象,按照随机数字表法分为对照组和观察组,各48例。2组均予常规治疗,对照组另加甲泼尼龙静脉注射,观察组在对照组治疗的基础上再加布地奈德雾化吸入治疗,疗程均为7~10 d。观察2组患者治疗后临床疗效。比较2组患者治疗前后肺功能、血气分析指标、炎性因子、免疫球蛋白及外周血白细胞CD64和CD11b指数水平变化。结果观察组治疗总有效率为91.67%,高于对照组的66.67%(χ~2/P=9.095/0.003)。与治疗前比较,2组患者疗后肺功能指标、血气分析指标、血清免疫球蛋白及外周血白细胞CD11b指数明显升高,血清炎性因子及外周血白细胞CD64指数明显降低,且观察组上述指标较对照组改善更为显著,差异均有统计学意义(P均<0.01)。结论甲泼尼龙联合布地奈德雾化吸入治疗AECOPD患者,可以更好地提高患者的肺功能,减轻炎性反应,增强机体免疫力,改善外周血白细胞CD64和CD11b指数,具有一定的临床应用价值。Objective To observe the effect of methylprednisolone combined with budesonide inhalation on inflammatory factors and CD64 and CDllb index of peripheral blood leukocytes in patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD).Methods From July 2017 to May 2019,96 patients with AECOPD were enrolled in the Department of Respiratory and Critical Care Medicine of the Second Clinical Medical College of Jilin Medical College/Meihekou Central Hospital.According to the random number table,48 cases were divided into control group and observation group.Both groups were given routine treatment,the control group plus methylprednisolone intravenous injection,the observation group based on the treatment of the control group plus budesonide atomization inhalation treatment,the course of treatment were 7-10 days.Observe the clinical effect of the two groups after treatment.The changes of lung function,blood gas analysis index,inflammatory factor,immunoglobulin,CD64 and CDllb index of peripheral blood leukocytes were compared before and after treatment.Results The total effective rate of treatment in the observation group was 91.67%,which was higher than66.67%in the control group(χ~2/P=9.095/0.003).Compared with before treatment,the lung function index,blood gas analysis index,serum immunoglobulin,and peripheral blood leukocyte CDllb index of the two groups of patients were significantly increased,and the serum inflammatory factors and peripheral blood leukocyte CD64 index were significantly reduced.Compared with the control group,the improvement was more significant,and the differences were statistically significant(all P<0.01).Conclusion Methylprednisolone combined with budesonide atomization inhalation in the treatment of AECOPD patients can better improve the lung function,reduce inflammatory response,enhance the body immunity,improve the peripheral blood leukocyte CD64 and CDllb index,which has a certain clinical application value.

关 键 词：甲泼尼龙 布地奈德 慢性阻塞性肺疾病 急性加重期 炎性因子 CD64指数 CD11b指数 

分 类 号：R563.9[医药卫生—呼吸系统]