前列地尔辅治慢性阻塞性肺疾病患者疗效及对血液流变学、肺动脉压、血气指标、IL-8、TNF-α和CRP的影响

Effects of the changes in serum IL-8,TNF-αand CRP levels of patients with chronic obstructive pulmonary disease in treatment with alprostadil

目的：观察前列地尔辅治慢性阻塞性肺疾病患者的疗效及对血液流变学、肺动脉压、血气指标、IL-8、TNF-α、CRP的影响。方法选择2012年3月—2014年9月接受治疗的慢性阻塞性肺疾病急性加重期患者82例，以随机数字表法分为2组，对照组40例，观察组42例。对照组患者应用常规综合治疗方法，观察组患者在此基础上加用前列地尔给予辅助治疗。治疗7 d后，比较2组患者的临床治疗效果及对IL-8、TNF-α和CRP的影响。结果观察组患者总有效率为90．5％，高于对照组的72．5％（χ2＝4．430， P ＜0．05）；血液流变学以及血气指标比较，2组患者均较治疗前显著改善（ P均＜0．05），且观察组较对照组改善更加显著（ P均＜0．05）；2组患者的肺动脉压、IL-8、TNF-α和CRP水平均较治疗前显著下降（ P均＜0．05），且观察组下降更加显著（ P ＜0．05）。结论前列地尔辅治慢性阻塞性肺疾病急性加重期患者，能够获得良好的效果，有助于患者病情的改善，具有重要的临床意义。

Objective To observe the curative effect of alprostadil assisted treatment efficacy in patients with chronic obstructive pulmonary disease （ COPD） and effect on hemorheology, pulmonary arterial pressure, blood gas index, IL-8, TNF-alpha, CRP.Methods From March 2012 to September 2014, 82 patients with chronic obstructive pulmonary disease a-cute exacerbation were enrolled, according to random number table, they were divided into two groups, 40 cases in the control group, 42 cases in observed group.The control group was treated with conventional therapy; patients in observation group were treated with alprostadil on the basis of adjuvant therapy.After 7 days treatment, compared 2 groups of patients’ clinical curative effect and effect on IL-8,TNF-alpha and CRP.Results In observation group, the total effective rate was 90.5%, which was higher than the control group of 72.5%（χ2 =4.430, P 〈0.05）;hemorheology and blood gas index comparison showed that, compared with before treatment, patients in both of the two groups were significantly improved （ P 〈0.05）, and the observation group’s improvement was more significant than in the control group （ P 〈0.05）;compared with before treat-ment, 2 groups of patients with pulmonary arterial pressure, IL-8, TNF-alpha and CRP levels were decreased significantly （P 〈0.05）, and the observation group were decreased more significantly （ P 〈0.05）.Conclusion Alprostadil as auxiliary treatment for chronic obstructive pulmonary disease in acute exacerbation can obtain good effect and help to improve patient＇s condition, which has important clinical significance.