吸入用布地奈德混悬液联合吸入用复方异丙托溴铵溶液治疗慢性阻塞性肺疾病急性加重期的疗效观察
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摘要
目的:探讨吸入用布地奈德混悬液联合吸入用复方异丙托溴铵溶液治疗慢性阻塞性肺疾病急性加重期的疗效。方法:选取2016年5月2018年10月中山市小榄人民医院收治的慢性阻塞性肺疾病急性加重期患者96例作为研究对象,以随机数字表法分为观察组和对照组,每组48例。对照组患者给予丙酸倍氯米松联合吸入用复方异丙托溴铵溶液雾化治疗,观察组患者给予吸入用布地奈德混悬液联合吸入用复方异丙托溴铵溶液雾化治疗。比较两组患者的临床疗效、血气指标[动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)及pH]、肺功能指标[用力肺活量(FVC)、1 s用力呼气容积(FEV_1)及FEV_1/FVC]及炎性因子[血清白细胞介素6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)及淀粉样蛋白A(SAA)]水平的差异。结果:观察组患者的总有效率为95.83%(46/48),明显高于对照组的85.42%(41/48),差异有统计学意义(P<0.05)。治疗后,两组患者PaO_2、pH较治疗前明显升高,PaCO_2较治疗前明显降低;且观察组患者PaO_2、pH明显高于对照组,PaCO_2明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者FVC、FEV_1及FEV_1/FVC水平较治疗前明显升高,且观察组患者明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者IL-6、CRP、PCT及SAA水平较治疗前明显降低,且观察组患者明显优于对照组,差异均有统计学意义(P<0.05)。观察组患者的不良反应发生率为4.17%(2/48),明显低于对照组的16.67%(8/48),差异有统计学意义(P<0.05)。结论:吸入用布地奈德混悬液联合吸入用复方异丙托溴铵溶液治疗慢性阻塞性肺疾病急性加重期的疗效显著,能够有效改善患者肺功能及血清炎性因子水平,安全性高,不良反应少。
OBJECTIVE: To probe into the efficacy of budesonide suspension for inhalation combined with compound ipratropium bromide solution for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS: 96 patients with AECOPD admitted into Zhongshan Xiaolan People's Hospital from May 2016 to Oct. 2018 were selected and divided into observation group and control group via random number table, with 48 cases in each group. The control group was given beclomethasone combined with compound ipratropium bromide solution for inhalation, while the observation group was given budesonide suspension for inhalation combined with compound ipratropium bromide solution for inhalation. Differences in clinical efficacy, indices of blood gas [arterial partial pressure of blood oxygen(PaO_2), arterial partial pressure of blood carbon dioxide(PaCO_2) and pH], indices of pulmonary function [forced vital capacity(FVC), forced expiratory volume in 1 s(FEV_1) and FEV_1/FVC] and inflammation factors [serum interleukin-6(IL-6), C-reactive protein(CRP), procalcitonin(PCT) and serum amyloid A(SAA)] between two groups were compared. RESULTS: The total effective rate of observation group was 95.83%(46/48), which was significantly higher than that of the control group(85.42%, 41/48), with statistically significant difference(P<0.05). After treatment, the PaO_2 and pH of both groups had been significantly improved, while the PaCO_2 was significantly decreased; the PaO_2 and pH of observation group were significantly higher than those of the control group, and the PaCO_2 of observation group was significantly lower, with statistically significant differences(P<0.05). After treatment, the FVC, FEV_1 and FEV_1/FVC of both groups were significantly increased, and those of observation group were significantly better than the control group, with statistically significant differences(P<0.05). After treatment, the IL-6, CRP, PCT and SAA levels of both groups were significantly decreased, and those of observation group were significantly better than the control group, with statistically significant differences(P<0.05). The incidence of adverse drug reactions of observation group was 4.17%(2/48), which was significantly lower than that of the control group(16.67%, 8/48), with statistically significant difference(P<0.05). CONCLUSIONS: The efficacy of budesonide suspension for inhalation combined with compound ipratropium bromide solution for inhalation in treatment of AECOPD is remarkable, which can effectively improve patients' pulmonary function and inflammation factor levels, with high safety and few adverse drug reactions.
OBJECTIVE: To probe into the efficacy of budesonide suspension for inhalation combined with compound ipratropium bromide solution for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS: 96 patients with AECOPD admitted into Zhongshan Xiaolan People's Hospital from May 2016 to Oct. 2018 were selected and divided into observation group and control group via random number table, with 48 cases in each group. The control group was given beclomethasone combined with compound ipratropium bromide solution for inhalation, while the observation group was given budesonide suspension for inhalation combined with compound ipratropium bromide solution for inhalation. Differences in clinical efficacy, indices of blood gas [arterial partial pressure of blood oxygen(PaO_2), arterial partial pressure of blood carbon dioxide(PaCO_2) and pH], indices of pulmonary function [forced vital capacity(FVC), forced expiratory volume in 1 s(FEV_1) and FEV_1/FVC] and inflammation factors [serum interleukin-6(IL-6), C-reactive protein(CRP), procalcitonin(PCT) and serum amyloid A(SAA)] between two groups were compared. RESULTS: The total effective rate of observation group was 95.83%(46/48), which was significantly higher than that of the control group(85.42%, 41/48), with statistically significant difference(P<0.05). After treatment, the PaO_2 and pH of both groups had been significantly improved, while the PaCO_2 was significantly decreased; the PaO_2 and pH of observation group were significantly higher than those of the control group, and the PaCO_2 of observation group was significantly lower, with statistically significant differences(P<0.05). After treatment, the FVC, FEV_1 and FEV_1/FVC of both groups were significantly increased, and those of observation group were significantly better than the control group, with statistically significant differences(P<0.05). After treatment, the IL-6, CRP, PCT and SAA levels of both groups were significantly decreased, and those of observation group were significantly better than the control group, with statistically significant differences(P<0.05). The incidence of adverse drug reactions of observation group was 4.17%(2/48), which was significantly lower than that of the control group(16.67%, 8/48), with statistically significant difference(P<0.05). CONCLUSIONS: The efficacy of budesonide suspension for inhalation combined with compound ipratropium bromide solution for inhalation in treatment of AECOPD is remarkable, which can effectively improve patients' pulmonary function and inflammation factor levels, with high safety and few adverse drug reactions.
引文
[1] 慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2014年修订版)[J].国际呼吸杂志,2014,34(1):1-11.
[2] Juanola PJ,Almagro MP,Soriano JB.Short and Medium Term Pro-gnosis in Patients Hospitalized for Acute Exacerbation of COPD(AECOPD): The CODEX Index[J].Chest,2014,145(3 Suppl):381A.
[3] Shi L,Zhu B,Xu M,et al.Selection of AECOPD-specific imm-unomodulatory biomarkers by integrating genomics and proteomics with clinical informatics[J].Cell Biol Toxicol,2018,34(2):109-123.
[4] 魏长宝.布地奈德联合可必特雾化吸入治疗COPD急性加重期疗效观察[J].现代医药卫生,2018,34(2):240-242.
[5] 唐海成,柏宏坚,张小薇.可必特、普米克令舒和万托林联合雾化吸入治疗COPD急性加重期患者的临床疗效观察[J].实用临床医药杂志,2015,19(23):31-33.
[6] 穆怀典,沈洁,周敏,等.可必特联合阿斯美治疗社区COPD疗效观察[J].中华全科医学,2015,13(6):984-985.
[7] 张朝阳,钟祥柱,罗润嫦,等.普米克令舒雾化吸入治疗慢性阻塞性肺病急性加重期并Ⅱ型呼吸衰竭临床分析[J].河北医药,2015,37(11):1709-1710.
[8] Sun X,He Z,Zhang J,et al.Compare the efficacy of inhaled bud-esonide and systemic methylprednisolone on systemic inflammation of AECOPD[J].Pulm Pharmacol Ther,2015,31:111-116.
[9] 王立,梁莉萍.普米克令舒联合孟鲁司特对慢性阻塞性肺疾病急性加重期的疗效分析[J].川北医学院学报,2017,32(3):336-338.
[10] 刘亚军,孙泰,冯德钢,等.普米克令舒治疗小儿哮喘急性发作的疗效及对肺功能的影响[J].中国妇幼保健,2016,31(11):2307-2308.
[11] 马艳,王宾友,易延静.甲强龙与普米克令舒在老年慢性阻塞性肺疾病急性加重期疗效观察[J].四川医学,2016,37(2):157-159.
[12] 郭小芙,吴允孚,曹一飞,等.联合应用普米克令舒与爱全乐雾化吸入治疗急诊AECOPD患者的临床效果[J].实用临床医药杂志,2014,18(23):140.
[13] 李建华,欧荣杰,刘志剑.沙丁胺醇、丙酸倍氯米松和溴化异丙托品联合雾化吸入治疗慢性阻塞性肺疾病急性加重[J].中华生物医学工程杂志,2014,20(3):248-251.
[14] 杨家民,付宇.布地奈德联合特布他林雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效研究[J].实用心脑肺血管病杂志,2014,22(2):31-33.
[15] 张春美,丁震,裴翀,等.无创机械通气联合经管道雾化吸入布地奈德治疗AECOPD合并Ⅱ型呼吸衰竭的疗效[J].实用医学杂志,2015,11(5):819-820.
[16] 付国昊.盐酸氨溴索及异丙托溴铵联合布地奈德治疗慢性阻塞性肺疾病急性加重患者的疗效观察[J].中华老年医学杂志,2015,34(9):979-980.
[2] Juanola PJ,Almagro MP,Soriano JB.Short and Medium Term Pro-gnosis in Patients Hospitalized for Acute Exacerbation of COPD(AECOPD): The CODEX Index[J].Chest,2014,145(3 Suppl):381A.
[3] Shi L,Zhu B,Xu M,et al.Selection of AECOPD-specific imm-unomodulatory biomarkers by integrating genomics and proteomics with clinical informatics[J].Cell Biol Toxicol,2018,34(2):109-123.
[4] 魏长宝.布地奈德联合可必特雾化吸入治疗COPD急性加重期疗效观察[J].现代医药卫生,2018,34(2):240-242.
[5] 唐海成,柏宏坚,张小薇.可必特、普米克令舒和万托林联合雾化吸入治疗COPD急性加重期患者的临床疗效观察[J].实用临床医药杂志,2015,19(23):31-33.
[6] 穆怀典,沈洁,周敏,等.可必特联合阿斯美治疗社区COPD疗效观察[J].中华全科医学,2015,13(6):984-985.
[7] 张朝阳,钟祥柱,罗润嫦,等.普米克令舒雾化吸入治疗慢性阻塞性肺病急性加重期并Ⅱ型呼吸衰竭临床分析[J].河北医药,2015,37(11):1709-1710.
[8] Sun X,He Z,Zhang J,et al.Compare the efficacy of inhaled bud-esonide and systemic methylprednisolone on systemic inflammation of AECOPD[J].Pulm Pharmacol Ther,2015,31:111-116.
[9] 王立,梁莉萍.普米克令舒联合孟鲁司特对慢性阻塞性肺疾病急性加重期的疗效分析[J].川北医学院学报,2017,32(3):336-338.
[10] 刘亚军,孙泰,冯德钢,等.普米克令舒治疗小儿哮喘急性发作的疗效及对肺功能的影响[J].中国妇幼保健,2016,31(11):2307-2308.
[11] 马艳,王宾友,易延静.甲强龙与普米克令舒在老年慢性阻塞性肺疾病急性加重期疗效观察[J].四川医学,2016,37(2):157-159.
[12] 郭小芙,吴允孚,曹一飞,等.联合应用普米克令舒与爱全乐雾化吸入治疗急诊AECOPD患者的临床效果[J].实用临床医药杂志,2014,18(23):140.
[13] 李建华,欧荣杰,刘志剑.沙丁胺醇、丙酸倍氯米松和溴化异丙托品联合雾化吸入治疗慢性阻塞性肺疾病急性加重[J].中华生物医学工程杂志,2014,20(3):248-251.
[14] 杨家民,付宇.布地奈德联合特布他林雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效研究[J].实用心脑肺血管病杂志,2014,22(2):31-33.
[15] 张春美,丁震,裴翀,等.无创机械通气联合经管道雾化吸入布地奈德治疗AECOPD合并Ⅱ型呼吸衰竭的疗效[J].实用医学杂志,2015,11(5):819-820.
[16] 付国昊.盐酸氨溴索及异丙托溴铵联合布地奈德治疗慢性阻塞性肺疾病急性加重患者的疗效观察[J].中华老年医学杂志,2015,34(9):979-980.