噻托溴铵粉吸入剂联合罗红霉素治疗稳定期支气管扩张症患者的疗效及对免疫功能的影响

Effect of Tiotropium Bromide Powder Inhalation Combined with Roxithromycin on Immune Function in Patients with Stable Bronchiectasis

目的分析稳定期支气管扩张症采用噻托溴铵粉吸入剂与罗红霉素联合治疗的效果及对患者免疫功能的影响。方法于宁夏回族自治区人民医院2016年6月—2018年6月期间收治的支气管扩张症患者中选取84例,随机分为两组,每组42例。对照组口服罗红霉素治疗,研究组联合应用罗红霉素与噻托溴铵粉吸入剂治疗,比较两组治疗效果。结果研究组治疗后临床症状评分为(1.5±0.6)分,呼吸困难评分为(1.9±0.5)分,均显著低于对照组的(2.6±0.9)分和(3.1±0.8)分,组间差异有统计学意义(P<0.05)。研究组治疗后的PaO2水平为(78.1±5.6)mm Hg、FEV1水平为(1.9±0.4)L,均显著高于对照组(P<0.05)。研究组与对照组治疗后FVC、PaCO2、PEF水平比较,差异无统计学意义(P>0.05)。研究组治疗后巨噬细胞比例为(34.8±7.9)%,中性粒细胞比例为(57.9±4.8)%,与对照组的(25.7±6.6)%和(68.3±5.7)%比较,差异均有统计学意义(P<0.05)。结论对稳定期支气管扩张症采用噻托溴铵粉吸入剂结合罗红霉素治疗,可有效缓解患者症状,改善患者肺功能和免疫功能,临床效果显著。

Objective To analyze the effect of tiotropium bromide powder inhalation combined with roxithromycin in the treatment of stable bronchiectasis and its influence on the immune function of patients.Methods 84 patients with bronchiectasis admitted to the hospital from June 2016 to June 2018 were divided into two groups,42 cases in each group.The control group was treated with roxithromycin orally and the study group was treated with roxithromycin and tiotropium bromide powder inhalation.The therapeutic effects of the two groups were compared.Results After treatment,the clinical symptom score and dyspnea score in the study group were(1.5±0.6)and(1.9±0.5)respectively,which were significantly lower than those in the control group[(2.6±0.9)and(3.1±0.8)].There was a significant difference between the two groups(P<0.05).After treatment,the levels of PaO2 and FEV1 in the study group were(78.1±5.6)mm Hg and(1.9±0.4)L,which were significantly higher than those in the control group(P<0.05).There was no significant difference in FVC,PaCO2 and PEF levels between the study group and the control group after treatment(P>0.05).After treatment,the proportion of macrophages and neutrophils in the study group was(34.8±7.9)%and(57.9±4.8)%.There were significant differences between the study group and the control group(25.7±6.6)%and(68.3±5.7)%(P<0.05).Conclusion Tiotropium bromide powder inhalation combined with roxithromycin can effectively relieve symptoms,improve pulmonary function and immune function of patients with stable bronchiectasis,and the clinical effect is remarkable.