复方异丙托溴铵联合普米克令舒治疗急性加重慢性阻塞性肺病的效果  

Effect of ipratropium bromide combined with pulmicort in the treatment of acute exacerbation of chronic obstructive pulmonary disease

作　　者：刘云[1] 张传名 LIU Yun;ZHANG Chuanming(Department of Respiratory Medicine,Taizhou Second People′s Hospital,Taizhou 225500,China;Department of Internal Medicine,Yangzhou Traditional Chinese Medicine Hospital,Yangzhou 225000,China)

机构地区：[1]泰州市第二人民医院呼吸内科,泰州225500 [2]扬州市中医院内科,扬州225000

出　　处：《西北药学杂志》2020年第3期431-435,共5页Northwest Pharmaceutical Journal

基　　金：江苏省中医药局科技项目(编号:LZ13189)。

摘　　要：目的研究复方异丙托溴铵联合普米克令舒治疗老年急性加重慢性阻塞性肺病(AECOPD)患者的临床疗效及对血清炎症因子的影响。方法选取医院收治的100例老年AECOPD患者为研究对象,依据随机数字表法均分为对照组和观察组,每组50例,在常规治疗基础上,观察组患者联合应用复方异丙托溴铵与普米克令舒治疗,对照组患者单独使用复方异丙托溴铵治疗,治疗10 d。分析2组患者的疗效、肺功能、血气指标、T细胞亚群和炎性因子、血清C反应蛋白(CRP)、血小板(PLT)、血清降钙素原(PCT)、肺部感染评分(CPIS)、呼吸困难(Borg)评分以及并发症之间的差异。结果观察组总有效率(90.00%)显著高于对照组(74.00%),观察组在5和10 d的第1秒用力呼气容积比例(FEV1%)、第1秒用力肺活量(FEV1)与用力肺活量(FVC)的比值(FEV1/FVC)和最大呼气流量(PEF)均显著高于对照组(P<0.05);治疗后氧分压(PaO2)和血氧饱和度(SpO 2)指标均显著低于观察组,二氧化碳分压(PaCO2)指标显著高于观察组(P<0.05);治疗后,2组患者的肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-8(IL-8)水平均明显下降,T细胞标志物CD3+、CD4+、CD8+和CD4+/CD8+水平明显升高,且治疗后观察组患者的TNF-α、IL-6和IL-8明显低于对照组,CD3+、CD4+、CD8+和CD4+/CD8+水平明显高于对照组;2组患者的CRP、PLT及PCT均显著下降,且观察组患者的CRP、PLT及PCT水平显著低于对照组;2组患者的CPIS和Borg评分显著下降,且观察组患者的CPIS、Borg评分显著低于对照组;2组患者的并发症比较差异无统计学意义。结论复方异丙托溴铵联合普米克令舒治疗老年AECOPD患者,其血清CRP、PLT及PCT水平显著下降,CPIS和Borg评分显著改善,疗效满意。Objective To study the effect of compound ipratropium bromide combined with pulmicort in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in the elderly.Methods 100 patients with AECOPD admitted to the hospital were selected as the research objects.According to the random number table method,they were divided into control group and observation group,50 cases in each group.Patients in observation group were treated with ipratropium bromide combined with pulmicort resuscitation on the basis of routine treatment,while patients in control group were treated with ipratropium bromide alone for 10 d.The differences of therapeutic effect,pulmonary function,blood gas index,T cell subsets and inflammatory factors,serum C-reactive proteir(CRP),platelet(PLT)and serum procalcitonin(PCT),pulmonary infection score(CPIS),Borg score of dyspnea and complications between the 2 groups were analyzed.Results The total effective rate of the observation group(90.00%)was significantly higher than that of the control group(74.00%).The FEV1%,FEV1/FVC and PEF of the observation group were significantly higher than those of the control group on 5 and 10 d(P<0.05).After treatment,the indexes of PaO2 and SpO 2 were significantly lower than those of the observation group,while the indexes of PaCO2 were significantly higher than those of the observation group(P<0.05).The levels of TNF-α,IL-6 and IL-8 of the 2 groups were significantly decreased,The levels of CD3+,CD4+,CD8+and CD4+/CD8+in the control group were significantly higher than those in the control group.After treatment,the levels of TNF-α,IL-6 and IL-8 in the observation group were significantly lower than those in the control group,and the levels of CD3+,CD4+,CD8+,CD4+/CD8+in the observation group were significantly higher than those in the control group.The levels of CRP,PLT and PCT in the 2 groups were significantly decreased,and the levels of CRP,PLT and PCT in the observation group were significantly lower than those in the control group.The sco

关 键 词：普米克令舒 复方异丙托溴胺 慢性阻塞性肺病 老年患者 降钙素 C反应蛋白 

分 类 号：R974[医药卫生—药品]