支气管肺泡灌洗术联合罗红霉素治疗支气管扩张并发肺部感染的临床疗效及对患者免疫功能与相关因子的影响探讨  

Clinical efficacy of bronchoalveolar lavage combined with roxithromycin in the treatment of bronchiectasis complicated with pulmonary infection and its influence on patients'immune function and related factors

作　　者：江山 王乐朋[1] 谢寒丹 岳春芽 谭琳[1] 李丽[1] JIANG Shan;WANG Le-peng;XIE Han-dan(Department of Respiratory Medicine,Dujiangyan People's Hospital,Dujiangyan 611830,China)

机构地区：[1]都江堰市人民医院呼吸与危重医学科,611830

出　　处：《中国现代药物应用》2022年第19期22-25,共4页Chinese Journal of Modern Drug Application

基　　金：都江堰市科技局项目(项目编号:2020SF03)。

摘　　要：目的 探究支气管肺泡灌洗术联合罗红霉素治疗支气管扩张并发肺部感染的临床疗效及对患者免疫功能与相关因子的影响。方法 40例支气管扩张并发肺部感染患者,按照抽签法分为对照组与观察组,各20例。对照组患者采用罗红霉素治疗,观察组患者在对照组基础上行支气管肺泡灌洗术治疗。对比两组临床效果,住院时长、血常规恢复正常时长、临床症状消失时长,动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))水平,免疫因子[辅助性T细胞1(Th1)/辅助性T细胞2(Th2)、CD3+、CD4+/CD8+]水平,炎性因子[白细胞介素-17(IL-17)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平。结果 观察组患者的临床总有效率为100.00%,显著高于对照组60.00%,差异具有统计学意义(P<0.05)。观察组住院时长(7.48±0.65)d、血常规恢复正常时长(2.74±1.32)d、临床症状消失时长(5.12±0.69)d均短于对照组的(12.36±1.55)、(4.59±1.56)、(9.69±1.74)d,差异具有统计学意义(P<0.05)。观察组PaCO_(2)(30.98±3.24)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(44.23±5.34)mm Hg,PaO_(2)(88.22±8.34)mm Hg高于对照组的(71.76±6.33)mm Hg,差异具有统计学意义(P<0.05)。观察组Th1/Th2(2.99±0.65)、CD3+(35.69±11.56)%、CD4+/CD8+(1.56±0.35)%均优于对照组的(3.79±0.54)、(26.88±12.69)%、(1.09±0.26),差异具有统计学意义(P<0.05)。观察组IL-17、IL-4、IL-6、TNF-α、hs-CRP分别为(27.69±1.40)ng/L、(25.69±1.12)ng/L、(27.48±1.95)ng/L、(5.79±2.11)ng/L、(8.48±0.36)mg/L,均低于对照组的(39.36±1.66)ng/L、(34.69±1.69)ng/L、(37.48±2.99)ng/L、(7.66±3.26)ng/L、(10.39±0.69)mg/L,差异具有统计学意义(P<0.05)。结论 支气管扩张并发肺部感染患者在罗红霉素治疗基础上应用支气管肺泡灌洗术治疗,不仅能够取得更为理想的临床疗效,还可以有效改善患者的免疫功能,减轻炎症反应,值得在临�Objective To investigate the clinical efficacy of bronchoalveolar lavage combined with roxithromycin in the treatment of bronchiectasis complicated with pulmonary infection and its influence on patients'immune function and related factors.Methods A total of 40 patients with bronchiectasis and pulmonary infection were divided into control group and observation group according to lottery method,with 20 cases in each group.Patients in the control group were treated with roxithromycin,and patients in the observation group were treated with bronchoalveolar lavage on the basis of the control group.Both groups were compared in terms of clinical effects,hospital stay,recovery time of blood routine,disappearance time of clinical symptoms,arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2))levels,immune factors[T helper cell type 1(Th1)/T helper cell type 2(Th2),CD3^(+),CD4^(+)/CD8^(+)]levels,inflammatory factors[interleukin-17(IL-17),interleukin-4(IL-4),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]levels.Results The total clinical effective rate of the observation group was 100.00%,which was significantly higher than 60.00%of the control group,and the difference was statistically significant(P<0.05).The hospital stay,recovery time of blood routine,and disappearance time of clinical symptoms of the observation group were(7.48±0.65),(2.74±1.32)and(5.12±0.69)d,which were shorter than(12.36±1.55),(4.59±1.56)and(9.69±1.74)d of the control group,and the differences were all statistically significant(P<0.05).The PaCO_(2)(30.98±3.24)mm Hg(1 mm Hg=0.133 kPa)of the observation group was lower than(44.23±5.34)mm Hg of the control group,and the PaO_(2)(88.22±8.34)mm Hg was lower than(71.76±6.33)mm Hg of the control group.The differences were all statistically significant(P<0.05).The Th1/Th2(2.99±0.65),CD3^(+)(35.69±11.56)%,and CD4^(+)/CD8^(+)(1.56±0.35)%in the observation group were better than(3.79±0.54),(26.88±12.69)%

关 键 词：支气管肺泡灌洗术 罗红霉素 支气管扩张并发肺部感染 免疫功能 炎性因子 

分 类 号：R563.1[医药卫生—呼吸系统] R562.22[医药卫生—内科学]