抗生素降阶梯疗法联合盐酸溴己新治疗支气管扩张伴感染的临床研究  

Clinical study of antibiotic step-down therapy combined with bromhexine hydrochloride in the treatment of bronchiectasis with infection

作　　者：李静[1] 纪伟 刘喜 LI Jing;JI Wei;LIU Xi(Department of Clinical Pharmacy,Xinhua Hospital of Huainan Xinhua Medical Group,Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology,Huainan 232052,Anhui,China;Department of Respiratory and Critical Care Medicine,Xinhua Hospital of Huainan Xinhua Medical Group,Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology,Huainan 232052,Anhui,China;Department of Pharmaceutical Equipment,Xinhua Hospital of Huainan Xinhua Medical Group,Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology,Huainan 232052,Anhui,China)

机构地区：[1]安徽理工大学附属淮南新华医院·淮南新华医疗集团新华医院临床药学室,安徽淮南232052 [2]安徽理工大学附属淮南新华医院·淮南新华医疗集团新华医院呼吸与危重症医学科,安徽淮南232052 [3]安徽理工大学附属淮南新华医院·淮南新华医疗集团新华医院药械科,安徽淮南232052

出　　处：《川北医学院学报》2024年第9期1195-1198,共4页Journal of North Sichuan Medical College

基　　金：安徽省重点研究与开发计划项目(2022e07020031)。

摘　　要：目的:探讨抗生素降阶梯疗法联合盐酸溴己新治疗支气管扩张伴感染的疗效。方法:纳入90例支气管扩张伴感染患者作为研究对象,按照治疗方式不同将患者分为对照组(n=45)和观察组(n=45)。对照组予以常规抗生素治疗;观察组予以抗生素降阶梯疗法联合盐酸溴己新治疗。比较两组患者临床疗效、症状改善时间及住院时间、治疗前后血气分析[动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能指标[第1秒用力呼气容积实测值与预测值百分比(FEV1%pred)、FEV1与用力肺活量比值(FEV1/FVC)]和血清炎症指标[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]。结果:观察组患者治疗显效率高于对照组(P<0.05);观察组患者各症状改善时间及住院时间均短于对照组(P<0.05)。治疗后,两组患者SaO_(2)、PaO_(2)均升高(P<0.05),且观察组高于对照组(P<0.05);PaCO_(2)均下降(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组患者FEV1%pred、FEV1/FVC均升高,且观察组均高于对照组(P<0.05);血清IL-6、TNF-α水平均降低,且观察组均低于对照组(P<0.05)。结论:抗生素降阶梯疗法联合盐酸溴己新治疗可以更好地促进支气管扩张伴感染患者临床症状和体征消失,改善血气和肺功能,减轻气道炎症,促进患者恢复健康。Objective:To explore the application effect of antibiotic step-down therapy combined with bromhexine hydrochloride treatment in patients with bronchiectasis and infection.Methods:90 patients with bronchiectasis and infection were selected and divided into a control group and an observation group according to different treatment methods.The control group(n=45)received routine antibiotic treatment,while the observation group(n=45)received antibiotic step-down therapy combined with bromhexine hydrochloride treatment.The clinical efficacy,symptom improvement time,hospitalization time,blood gas analysis before and after treatment[arterial oxygen saturation(SaO_(2)),arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2))],lung function indicators[percentage of measured and predicted value of forced expiratory volume at the first second(FEV1%pred),the first second(FEV1%pred)],and serum inflammation indicators[interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)]were compared between the two groups.Results:The efficacy of the treatment in the observation group was higher than that in the control group(P<0.05).The improvement and hospitalization duration in the observation group were shorter than those in the control group(P<0.05).After treatment,both groups experienced an increase in SaO_(2) and PaO_(2)(P<0.05),and a decrease in PaCO_(2)(P<0.05),with the observation group showing greater improvement in blood gas indices than the control group(P<0.05).Post-treatment,FEV1%pred and FEV1/FVC increased in both groups,with the observation group demonstrating higher values than the control group(P<0.05).Serum levels of IL-6 and TNF-αdecreased in both groups,and the observation group was lower than the control group(P<0.05).Conclusion:The combination of antibiotic downgrading therapy and bromhexine hydrochloride treatment can better promote the disappearance of clinical symptoms and signs in patients with bronchiectasis and infection,improve blood gas and lung function,alleviate airway

关 键 词：支气管扩张 感染 抗生素降阶梯疗法 盐酸溴己新 肺功能 炎症 

分 类 号：R562.22[医药卫生—呼吸系统]