左氧氟沙星对慢性阻塞性肺疾病急性发作患者血液多索茶碱浓度的影响

Effects of levofloxacin on serum concentration of doxofylline in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨左氧氟沙星对慢性阻塞性肺疾病急性发作患者血液多索茶碱浓度的影响。方法选取本院2011年1月至2012年11月慢性阻塞性肺疾病急性加重患者92例,经患者及家属知情同意并签署同意书后,随机分为2组,46例患者静脉滴注多索茶碱为对照组,46例患者静脉滴注左氧氟沙星和多索茶碱为观察组,疗程10 d。检测2组患者第1、4、7、10天血液中多索茶碱浓度,分析临床疗效与不良反应情况。结果观察组治疗每天的多索茶碱浓度均略高于对照组,但差异均无统计学意义(P>0.05)。观察组总有效率(97.8%)明显高于对照组(84.8%),差异有统计学意义(P<0.05)。观察组不良反应发生率(8.7%)高于对照组(2.2%),但差异无统计学意义(P>0.05)。结论左氧氟沙星不会对慢性阻塞性肺疾病急性加重患者血液多索茶碱浓度造成显著影响,2种药物联合使用可显著提高治疗效果,安全性较高,值得临床推广使用。

Objective To investigate effects of levofloxacin on serum concentration of doxofylline in patients with acute exac- erbation of chronic obstructive pulmonary disease. Methods A total of 92 patients with acute exacerbation of chronic obstructive pul- monary disease were selected from our hospital from January 2011 to November 2012. With the knowledge and consent of the patients and following the signing of the letter of agreement, the patients were randomly divided into 2 groups ： the control group that received in- travenous doxofylline （ n = 46） and the observation group that received intravenous levofloxacin ± doxofylline （ n = 46） , all with a treatment course of 10 days. Serum levels of doxofylline in patients of both groups were detected at d 1, d 4, d 7 and d 10, and clinical therapeutic effects and adverse reactions were analyzed carefully. Results Doxofylline serum concentrations at d 1 [ （5.0 ± 1.3） mg/L）, d 4 [ （4.9 ± 1.2） mg/L, d 7 [ （4.6 ± 1.0） mg/L and dl0 [ （4.5 ± 1.2） mg/L] for the animals of the observation group were all higher than those of the control group [ （4.7 ± 1.2）, （4.6 ± 1.1 ）, （4.5 ±0.9） and （4.3 ± 1.0） mg/L） ], but without statistical significance （P 〉0.05）. Total effective rate for the observation group （97.8%） was significantly higher than that for the control group （84.8%）, with statistical significance （P 〈0.05）. Adverse reaction incidence for the observation group （8.7%） was higher than that for the control group （2.2%）, but without statistical significance （P 〉0.05）. Conclusion Levofloxacin didn＇t seem to have significant effects on ser- um doxofylline concentration of patients with acute exacerbation of chronic obstructive pulmonary disease. The combined use of the 2 drugscould significantly improve therapeutic effect and proved to be safer. Therefore, it is worth further clinical application.