布地奈德联合氨溴索雾化吸入治疗慢性阻塞性肺疾病急性加重期的临床疗效  

Clinical efficacy of budesonide combined with ambroxol aerosol inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease

作　　者：曾令文[1] 陈贤胜[2] 陈德武 胡冲[1] ZENG Lingwen;CHEN Xiansheng;CHEN Dewu;HU Chong(Department of Emergency,the Second People′s Hospital of Hainan Province,Hainan Province,Wuzhishan 572299,China;不详)

机构地区：[1]海南省第二人民医院急诊科,海南省五指山市572299 [2]海南省第二人民医院呼吸内科,海南省五指山市572299

出　　处：《临床合理用药杂志》2023年第5期12-14,18,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察布地奈德联合氨溴索雾化吸入治疗慢性阻塞性肺疾病(COPD)急性加重期的临床疗效。方法选择2019年1月—2020年12月海南省第二人民医院急诊科收治的COPD急性加重期患者72例,采用随机数字表法分为观察组和对照组,每组36例。对照组患者予以常规强心利尿、止咳平喘等对症治疗,观察组患者在对照组治疗的基础上予以布地奈德联合氨溴索雾化吸入,2组均治疗1周。比较2组患者临床疗效、治疗前后动脉血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、B型钠尿肽(BNP)水平、肺动脉压、炎性指标[C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、白细胞(WBC)计数]及不良反应。结果观察组患者总有效率为88.89%,高于对照组的66.67%(χ^(2)=5.143,P=0.023)。治疗1周后,2组患者的PaO_(2)均高于治疗前,PaCO_(2)、BNP水平及肺动脉压均低于治疗前,且观察组患者PaO_(2)高于对照组,PaCO_(2)、BNP水平均低于对照组(P<0.01),2组患者肺动脉压比较差异无统计学意义(P>0.05)。治疗1周后,2组患者CRP、NLR及WBC计数均低于治疗前,且观察组低于对照组(P<0.01)。对照组与观察组患者不良反应总发生率比较差异无统计学意义(5.56%vs.11.11%,χ^(2)=0.727,P=0.394)。结论布地奈德联合氨溴索雾化吸入治疗COPD急性加重期可有效改善动脉血气分析指标、BNP、肺动脉压及炎性因子水平,安全有效,无明显不良反应,值得临床应用推广。Objective To observe the clinical effect of budesonide combined with ambroxol inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 72 patients with COPD acute exacerbation admitted to Department of Emergency,the Second People′s Hospital of Hainan Province from January 2019 to December 2020 were selected and divided into observation group and control group by random number table method,with 36 cases in each group.Control group was given conventional symptomatic treatment such as strong heart diuresis,relieving cough and relieving asthma,observation group was given budesonide combined with ambroxol atomized inhalation on the basis of control group.Both groups were treated for 1 week.The clinical efficacy,arterial blood gas analysis indexes[arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2))],B-type natriuretic peptide(BNP)level,pulmonary artery pressure,inflammatory indexes[C-reactive protein(CRP),neutrophil/lymphocyte(NLR),white blood cell count(WBC)]before and after treatment and adverse reactions were compared between 2 groups.Results The total effective rate in the observation group was 88.89%,higher than 66.67%in the control group(χ^(2)=5.143,P=0.023).After one week of treatment,PaO_(2) of patients in both groups were higher than that before treatment,PaCO_(2),BNP levels and pulmonary artery pressure were lower than those before treatment,and PaO_(2) of patients in the observation group was higher than that in the control group,PaCO_(2),BNP levels were lower than those in the control group(P<0.01),and there were no statistical significance in the comparison of pulmonary artery pressure between the two groups(P>0.05).After one week of treatment,the levels of CRP,NLR and WBC in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the cont

关 键 词：慢性阻塞性肺疾病 急性加重期 布地奈德 氨溴索 临床疗效 

分 类 号：R563.9[医药卫生—呼吸系统]