已酮可可碱吸入对慢性阻塞性肺疾病患者的疗效观察

The Effects of Pentoxifylline on Patients with Chronic Obstructive Pulmonary Disease

目的：分析吸入己酮可可碱（ｐｅｎｔｏｘｉｆｙｌｌｉｎｅ，ＰＴＸ，商品名潘通）治疗慢性阻塞性肺疾病（ＣＯＰＤ）患者的疗效。方法：ＣＯＰＤ急性加重期患者 ２９例，随机分为两组：（１）治疗组：ＰＴＸ １００ ｍｇ加入生理盐水 ５ｍｌ经超声雾化吸入；（２）对照组：糜蛋白酶 ５ｍｇ加入生理盐水 ５ ｍｌ超声雾化吸入。均为每日 ２次，疗程 ２周。治疗前后常规检查肺功能、动脉血气、肝肾功能、血浆白细胞介素－８（ＩＬ—８）、超氧歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）。并观察药物不良反应。结果：治疗组患者治疗后ＩＬ—８、ＭＤＡ均下降，ＳＯＤ明显增高（Ｐ＜０．０１）；对照组ＳＯＤ不升反降，ＭＤＡ不降反升，有显著差异（Ｐ分别＜０．０１和＜０．０５）。对照组治疗后 ＩＬ— ８虽有降低，但下降幅度较治疗组小。治疗组在治疗后 Ｐａ ＣＯ２下降，有显著差异（Ｐ＜ ０． ０１）；两组治疗后 ＰａＯ２、ＳａｔＯ２％均有增高。２组治疗前后ＦＥＶ１、ＦＥＶ１％变化均无显著差异（Ｐ＞０． ０５）。两组患者均未发现肝、肾功能损害。除患者反映口感较苦外，无特殊不良反应发生。结论：ＰＴＸ不但抑制中性粒细胞的趋化、募集，抑制中性粒细胞产生ＩＬ—８。

Objective: To evaluate the effect of pentoxifylline (PTX) on patients with chronic obstructive pulmonary disease (COPD) in exacerbation status. Methods: 29 COPD patients who were in exacerbation status were randomly divided to two groups, the treatment group (TG) and control group (CG). 1. The TG (14 cases) inhaled solution consisting of PTX 100mg and 5ml normal saline solution; 2. The CG (15 cases) inhaled solution including 5ml chymotrypsin and 5ml normal saline solution. Both groups inhaled twice daily for two weeks. Before and after treatment, lung function, artery gas analysis, liver and kidney function, IL - 8 and SOD, MDA were detected, and differences were compared between two groups. The side effects were recorded. Results: after treatment, there were significant changes in TG, the level of serum IL - 8, MDA and PaCO2, SOD increased (P< 0. 01), Compared with the TG. The level of SOD decreased and MDA increased. Though the level of serum IL - 8 of patients in CG was lower than TG, PaCO2, Sat. O2% were increased in both of two groups. There were not significant Changes of FEV1, FEV1 % between pre and post treatment of all case. There were no side effects recorded. Conclusion: PTX not only inhibits neutrophils recruit, but also inhibits neutrophils releasing oxidant. PTX is a cheap, tolerable safe drug for airway inflammation of COPD patients.