热毒宁注射液联合布地奈德与氨溴索吸入对AECOPD患者炎症反应及痰液MUC5AC、NE、MMP-9的影响  

Effects of Reduning injection combined with budesonide and ambroxol inhalation on inflammation and sputum MUC5AC,NE and MMP-9 in patients with AECOPD

作　　者：丁李诚 孙炜 DING Li-cheng;SUN Wei(Emergency Medicine Department,Affiliated Hospital of Jiangnan University,Wuxi 214000,China)

机构地区：[1]江南大学附属医院急诊医学科,214000

出　　处：《中国现代药物应用》2024年第22期6-11,共6页Chinese Journal of Modern Drug Application

基　　金：无锡市卫生健康委科研项目(项目编号:M202109)。

摘　　要：目的 观察热毒宁注射液联合布地奈德与氨溴索吸入对慢性阻塞性肺疾病急性加重期(AECOPD)患者炎症反应及痰液粘蛋白(MUC)5AC、中性粒细胞弹力蛋白酶(NE)、基质金属蛋白酶-9(MMP-9)的影响。方法 将采用常规治疗+布地奈德与氨溴索吸入+热毒宁注射液治疗的66例AECOPD患者作为试验组,另选取同期采用常规治疗+布地奈德与氨溴索吸入治疗的66例AECOPD患者作为基础组。比较两组肺功能[第1秒用力呼气容积占预计值百分比(FEV1%pred)和用力肺活量(FVC)]水平,痰液中MUC5AC、NE、MMP-9水平,血清中相关因子[超敏C反应蛋白(hs-CRP)、白细胞介素-17(IL-17)、LIN-28同系物B(LIN28B)、趋化因子配体-18(CCL18)、Clara细胞蛋白(CC16)]水平,血气指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、酸碱度(pH值)]水平,慢性阻塞性肺疾病晨间症状量表(COPD-MSD)评分、中医症状评分,不良反应发生情况。结果 两组治疗后FEV1%pred和FVC较治疗前升高,且试验组治疗后FEV1%pred(65.45±8.52)%和FVC(2.69±0.47)L较基础组的(58.41±7.33)%、(2.28±0.42)L更高(P<0.05)。两组治疗后痰液中MUC5AC、NE、MMP-9较治疗前降低,且试验组治疗后痰液中MUC5AC(93.45±43.13)ng/ml、NE(1.17±0.21)ng/ml、MMP-9(87.14±25.54)ng/ml较基础组的(115.41±52.08)、(1.30±0.26)、(101.56±33.69)ng/ml更低(P<0.05)。两组治疗后血清hs-CRP、IL-17、LIN28B、CCL18较治疗前降低,且试验组治疗后血清hs-CRP(45.06±6.92)mg/L、IL-17(25.12±3.64)pg/ml、LIN28B(6.64±1.63)ng/ml、CCL18(3.45±0.82)ng/ml较基础组的(64.12±7.74)mg/L、(30.47±4.17)pg/ml、(7.76±1.87)ng/ml、(4.67±1.08)ng/ml更低(P<0.05);两组治疗后血清CC16较治疗前升高,且试验组治疗后血清CC16(76.31±10.11)μg/L较基础组的(71.43±9.32)μg/L更高(P<0.05)。两组治疗后PaO2、OI、pH值较治疗前升高,且试验组治疗后PaO2(86.21±8.23)mm Hg(1 mm Hg=0.133 kPa)、OI(268.14±41.15)mm Hg、pH值(7.43Objective To observe the effects of thermotoxic injection combined with budesonide and ambroxol inhalation on inflammatory response and sputum mucin(MUC) 5AC,neutrophil elastase(NE),and matrix metalloproteinase-9(MMP-9) in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 66 AECOPD patients treated with conventional therapy + budesonide and ambroxol inhalation + Reduning injection were selected as the experimental group.Another 66 AECOPD patients treated with conventional therapy + budesonide and ambroxol inhalation were selected as the basic group.Both groups were compared in terms of levels of lung function [forced expiratory volume in one second as a percentage of the predicted value(FEV1%pred) and forced vital capacity(FVC)],sputum levels of MUC5AC,NE,and MMP-9,and serum levels of related factors [high-sensitivity C-reactive protein(hs-CRP),interleukin-17(IL-17),and lin-28 homolog B(LIN28B),chemokine ligand 18(CCL18),Clara cell protein 16(CC16)],blood gas indicators [arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI),and pH value] levels,Chronic Obstructive Pulmonary Disease Morning Symptom Diary(COPDMSD) score,traditional Chinese medicine syndrome score,and adverse reactions occurrence.Results After treatment,FEV1%pred and FVC in both groups were higher than those before treatment;the experimental group had FEV1%pred of(65.45±8.52) % and FVC of(2.69±0.47) L,which were higher than(58.41±7.33) % and(2.28±0.42) L in the basic group(P<0.05).After treatment,the sputum MUC5AC,NE and MMP-9 in both groups were lower than those before treatment;the experimental group had MUC5AC of(93.45±43.13) ng/ml,NE of(1.17±0.21) ng/ml,and MMP-9 of(87.14±25.54) ng/ml,which were lower than(115.41±52.08),(1.30±0.26),and(101.56±33.69) ng/ml in the basic group(P<0.05).After treatment,the serum hs-CRP,IL-17,LIN28B and CCL18 in both groups were lower than those before treatment;the experimental group had serum hs-CRP o

关 键 词：热毒宁注射液 慢性阻塞性肺疾病 粘蛋白5AC 急性加重期 布地奈德 氨溴索 炎症反应 

分 类 号：R563.9[医药卫生—呼吸系统]