氨溴索联合抗结核治疗慢性阻塞性肺疾病合并肺结核的临床疗效及安全性分析  

Analysis of efficacy and safety of ambroxol combined with antituberculosis therapy in the treatment of chronic obstructive pulmonary disease with pulmonary tuberculosis

作　　者：王倩 戎燕筱 孙雪培 王海宾[1] 王慰[1] 苏圆圆[1] WANG Qian;RONG Yan-xiao;SUN Xue-pei;WANG Hai-bin;WANG Wei;SU Yuan-yuan(Shijiazhuang Fifth Hospital,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市第五医院,河北石家庄050021

出　　处：《实用医院临床杂志》2024年第2期66-69,共4页Practical Journal of Clinical Medicine

基　　金：河北省医学科学研究课题(编号:20220203)。

摘　　要：目的探讨氨溴索联合抗结核治疗在慢性阻塞性肺疾病(COPD)合并肺结核中的应用效果。方法选取2019年1月至2021年6月我院收治的96例COPD合并肺结核患者,按照随机数字表法分为治疗组(n=48)与对照组(n=48),对照组予以2HRZE/4HR方案四联抗结核,治疗组予以氨溴索+2HRZE/4HR方案治疗。治疗后6个月末,比较两组患者抗结核效果、肺功能、炎症水平及生活质量,记录不良反应。结果治疗后6个月末,治疗组痰菌阴转率97.92%、病灶显著吸收率93.75%、空洞缩小闭合率89.58%,显著高于对照组(P<0.05);两组用力肺活量(FVC)、1s用力呼气容积(FEV_(1))、FEV_(1)/FVC及呼气峰流速(PEF)均较治疗前升高(P<0.05),且治疗组FVC、FEV_(1)、FEV_(1)/FVC、PEF水平高于对照组(P<0.05);两组血清C-反应蛋白(CRP)、干扰素-γ(IFN-γ)、白介素-6(IL-6)、可溶性白细胞介素-2受体(sIL-2R)水平均较治疗前下降(P<0.05),且治疗组CRP、IFN-γ、IL-6、sIL-2R水平低于对照组(P<0.05);两组圣乔治呼吸问卷(SGRQ)中各维度得分均降低(P<0.05),且治疗组得分低于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论氨溴索用于COPD合并肺结核治疗,可提高抗结核效果,可能与其能改善肺功能、减轻炎症水平有关,有助于提高患者生活质量,且安全性好。Objective To explore the application effects of ambroxol combined with anti-tuberculosis therapy in the treatment of chronic obstructive pulmonary disease(COPD)with pulmonary tuberculosis.Methods Ninety-six patients with COPD complicated with pulmonary tuberculosis from January 2019 to June 2021 were selected.They were divided into a control group and a treatment group by using random number table method,48 in each group.The control group was treated with quadruple anti tuberculosis(2hrze/4hr regimen),and the treatment group was given ambroxol+2HRZE/4HR regimen.At the end of 6 months after treatment,the antituberculosis effect,pulmonary function,inflammation level and quality of life were compared between the two groups.The adverse reactions were recorded.Results At the end of 6 months after treatment,the sputum negative conversion rate was 97.92%,the lesion significant absorption rate was 93.75%and the cavity narrowing closure rate was 89.58%in the treatment group,which were higher than those in the control group(P<0.05).The forced vital capacity(FVC),forced expiratory volume in 1s(FEV_(1)),FEV_(1)/FVC and peak expiratory flow rate(PEF)in both groups at the end of 6 months after treatment were increased compared to before treatment(P<0.05),and the FVC,FEV_(1),FEV_(1)/FVC and PEF in treatment group were higher than those in the control group(P<0.05).Serum levels of C-reactive protein(CRP),interferon-γ(IFN-γ),interleukin-6(IL-6)and soluble interleukin-2 receptor(SIL2R)at the end of 6 months after treatment were decreased in both groups(P<0.05),and the levels were lower in treatment group compared to the control group(P<0.05).The scores of dimensions of St.George Respiratory Questionnaire(SGRQ)in the two groups were reduced at the end of 6 months after treatment(P<0.05),and the scores were lower in the treatment group(P<0.05).There were no statistical differences in the adverse reactions between the two groups(P>0.05).Conclusions Ambroxol in the treatment of patients with COPD and pulmonary tuberculosis can enhan

关 键 词：慢性阻塞性肺疾病 肺结核 氨溴索 抗结核化疗 肺功能 

分 类 号：R563[医药卫生—呼吸系统]