糜蛋白酶联合布地格福治疗AECOPD的效果及其机制  

Efficacy of chymotrypsin combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease and its mechanism

作　　者：刘改莲 刘待见[2] 侯志慧 朱早君 苏郑刚 LIU Gailian;LIU Daijian;HOU Zhihui;ZHU Zaojun;SU Zhenggang(Department of Respiratory Medicine,Staff General Hospital,Anyang Iron and Steel Group Co.,LTD.,Anyang 455000,China)

机构地区：[1]安阳钢铁集团有限责任公司职工总医院呼吸内科,河南安阳455000 [2]郑州大学第二附属医院呼吸与危重症医学科

出　　处：《青岛大学学报（医学版）》2024年第5期743-746,共4页Journal of Qingdao University(Medical Sciences)

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210879)。

摘　　要：目的探讨糜蛋白酶联合布地格福治疗慢性阻塞性肺疾病急性加重期(AECOPD)病人的效果及其作用机制。方法选取120例AECOPD病人为研究对象,随机分为研究组和对照组,各60例。研究组治疗方式为基础治疗+糜蛋白酶+布地格福,对照组治疗方式为基础治疗+布地格福,疗程均为4周。比较两组治疗前及治疗4周后肺功能指标、血气分析指标、外周血环状RNA-同源域结合蛋白激酶3(circRNA-HIPK3)和黏蛋白5AC(MUC5AC)水平及临床疗效差异。结果两组治疗前肺功能指标第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、呼气峰值流速(PEF)差异无显著意义(P>0.05);研究组FEV1、FVC、PEF治疗前后差值大于对照组,差异有统计学意义(t=2.840~10.626,P<0.05)。两组治疗前血气分析指标pH、PaO_(2)、PaCO_(2)差异无显著性(P>0.05);研究组pH、PaO_(2)、PaCO_(2)治疗前后差值均大于对照组,差异有统计学意义(t=6.331~6.416,P<0.05)。两组治疗前外周血circRNA-HIPK3、MUC5AC水平差异无显著性(P>0.05);研究组外周血circRNA-HIPK3、MUC5AC水平治疗前后差值均大于对照组(t=2.833、3.250,P<0.05)。研究组治疗效果优于对照组(Z=-1.461,P<0.05)。结论糜蛋白酶联合布地格福治疗更有利于改善AECOPD病人肺功能、血气指标,降低外周血circRNA-HIPK3、MUC5AC水平,提高临床治疗效果。Objective To explore the therapeutic effect of chymotrypsin combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its mechanism.Methods A total of 120 patients with AECOPD were selected and randomly divided into study group and control group,with 60 cases in each group.The treatment method for the study group was basic therapy+chymotrypsin+budesonide,and the treatment method for the control group was basic therapy+budesonide.The course of treatment was 4 weeks.The pulmonary function indices,blood gas analysis indices,peripheral circRNA homeodomain-interacting protein kinase 3(circRNA-HIPK3),mucin 5AC(MUC5AC),and clinical efficacy were compared between the two groups before treatment and after 4 weeks of treatment.Results There were no significant diffe-rences in the baseline levels of the first second forced expiratory volume(FEV1),forced vital capacity(FVC),FEV1/FVC,and end-expiratory peak flow rate(PEF)before treatment between the two groups(P>0.05).The changes in FEV1,FVC,and PEF after treatment in the study group were significantly greater than those in the control group(t=2.840-10.626,P<0.05).There were no significant differences in pH,PaO_(2),and PaCO_(2) between the two groups before treatment(P>0.05);the changes in pH,PaO_(2),and PaCO_(2) after treatment in the study group were significantly greater than those in the control group(t=6.331-6.416,P<0.05).There were no significant differences in circRNA-HIPK3 and MUC5AC levels between the two groups before treatment(P>0.05);the changes in circRNA-HIPK3 and MUC5AC in peripheral blood after treatment in the study group were significantly greater than those in the control group(t=2.833,3.250;P<0.05).The treatment effect of the study group was significantly better than that of the control group(Z=-1.461,P<0.05).Conclusion Treatment with chymotrypsin plus budesonide is more effective in improving lung function and blood gas indices in patients with AECOPD,reducing circRNA-HIPK3 and MUC5AC levels in per

关 键 词：糜蛋白酶 布地格福 肺疾病 慢性阻塞性 呼吸功能试验 环状RNA-同源域结合蛋白激酶3 黏蛋白5AC 

分 类 号：R563.9[医药卫生—呼吸系统]