盐酸氨溴索肺泡灌洗治疗老年脑梗死合并吸入性肺炎疗效及对血清炎症细胞因子的影响  

Efficacy of ambroxol hydrochloride alveolar lavage in the treatment of elderly patients with cerebral infarction combined with aspiration pneumonia and its effect on serum inflammatory cytokines

作　　者：罗文[1] 义艳 邱容[1] Luo Wen;Yi Yan;Qiu Rong(Department of Respiratory and Critical Care Medicine,Suining Central Hospital,Suining,Sichuan,629000,P.R.China)

机构地区：[1]遂宁市中心医院呼吸与危重症医学科,四川遂宁629000

出　　处：《老年医学与保健》2021年第6期1182-1185,共4页Geriatrics & Health Care

摘　　要：目的观察盐酸氨溴索经纤支镜支气管肺泡灌洗术治疗老年脑梗死并吸入性肺炎患者的疗效及对血清IL-6、TNF-和hs-CRP的影响。方法选取2018年10月—2020年10月于遂宁市中心医院收治的老年脑梗死合并吸入性肺炎患者70例,通过随机数字表法分为观察组和对照组,每组35例。对照组经纤支镜支气管肺泡灌洗术给予生理盐水,观察组经纤支镜支气管肺泡灌洗术给予盐酸氨溴索进行治疗。比较2组及不同性别患者的疗效,在治疗前后测量血清中IL-6、TNF-和hs-CRP水平,并进行安全性评估。结果对照组中显效7例,有效22例,无效6例,有效率为82.86%;观察组中显效20例,有效12例,无效3例,有效率为91.43%;2组的总有效率比较差异无统计学意义(P>0.05)。治疗前,2组IL-6、TNF-和hs-CRP水平差异无统计学意义(P>0.05);治疗后,同组血清IL-6、TNF-和hs-CRP水平与治疗前相比,差异有统计学意义(P<0.05);治疗后,IL-6水平在2组中所有的差异有统计学意义(P<0.05),TNF-水平在2组中所有的差异有统计学意义(P<0.05),hs-CRP水平在2组中所有的差异有统计学意义(P<0.05)。2组患者不良反应比较差异无统计学意义(P>0.05)。结论老年脑梗死合并吸入性肺炎的患者,在纤支镜支气管肺泡灌洗术中联合应用盐酸氨溴索治疗是有效而安全的方法,能够降低患者的免疫炎症反应,在一定程度上改善自身的免疫功能,具有一定的应用价值。Objective To observe the curative effect of bronchoalveolar lavage of ambroxol hydrochloride via bronchoscopy in the treatment of elderly patients with cerebral infarction complicated with aspiration pneumonia and its effect on serum IL-6,TNF-and hs-CRP.Methods 70 elderly patients with cerebral infarction complicated with aspiration pneumonia treated in Suining Central Hospital from October 2018 to October 2020 were selected and randomly divided into the observation group and control group,with 35 cases in each group.The control group was treated with normal saline for bronchoalveolar lavage through fiberbronchoscope,and the observation group was treated with ambroxol hydrochloride for bronchoalveolar lavage through fiberbronchoscope.The curative effects of the two groups and patients of different genders were compared.The levels of serum IL-6,TNF-and hs-CRP were measured before and after treatment.The safety of treatment was evaluated.Results In the control group,7 cases were markedly effective,22 cases were effective,6 cases were ineffective,and the total effective rate was 82.86%.In the observation group,20 cases were markedly effective,12 cases were effective,3 cases were ineffective,and the total effective rate was 91.43%.There was not significant difference in the total effective rate between the two groups(P>0.05).Before treatment,there was no significant difference in the levels of serum IL-6,TNF-and hs-CRP between the two groups(P>0.05).After treatment,the levels of serum IL-6,TNF-and hs-CRP of the two groups were significantly lower than those of the same group before treatment,and the levels of serum IL-6,TNF-and hs-CRP of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion In elderly patients with cerebral infarction complicated with aspiration pneumonia,the combined application of ambroxol hydrochloride for bronchoalveolar lavage through fiberbronchoscope is an effecti

关 键 词：老年 脑梗死 吸入性肺炎 炎症反应 盐酸氨溴索 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R563.1[医药卫生—临床医学]