大剂量氨溴索治疗老年重症肺炎的临床研究

Clinical effect of high-dose ambroxol in the treatment of severe pneumonia in the elderly

目的:探讨静脉滴注大剂量氨溴索在老年重症肺炎患者治疗中的应用价值。方法:选择老年重症肺炎患者51例,随机分为治疗组与对照组,两组患者均进行抗感染等系统治疗。对照组予常规剂量盐酸氨溴索60 mg加生理盐水100 ml,2次/d静脉滴注;治疗组予大剂量氨溴索900 mg+生理盐水100 ml缓慢静脉滴注(时间>4 h),1次/d。两组疗程均为14 d。观察临床肺部感染评分(CPIS)、炎性指标、血气分析及肝、肾功能等指标的变化。结果:治疗14 d后,治疗组CPIS及炎性指标明显低于对照组,差异有统计学意义(P<0.05),SPO2及Pa O2/Fi O2等血气指标则明显高于对照组,差异有统计学意义(P<0.05);死亡率则明显低于对照组,差异有统计学意义(P<0.05);两组治疗前后肝肾功能均差异无统计学意义(P>0.05)。结论:大剂量氨溴索治疗老年重症肺炎患者具有较好的疗效和安全性。

Objective To observe the effect of high-dose ambroxol in the treatment of severe pneumonia in the elderly. Method 51 senior patients with severe pneumonia were selected in intensive care unit（ ICU） and divided into the control group and the study group randomly. All of the patients were given conventional treatment. The control group was given intravenously ambroxol with 60 mg,twice per day,while the study group was given large doses of intravenously with 900 mg,one time per day. The treatment lasted 14 d. The clinical pulmonary infection score（ CPIS） and inflammatory indicators,arterial blood gas,hepatic and renal function were detected to compare between the two groups. Results After the treatment,the CPIS and the inflammatory indicators of study group were significantly decreased than those of the control group,the difference was statistically significant（ P〈0. 05）. The indexes of blood oxygen pressure and oxygenation were obviously higher in the study group than in the control,the difference was statistically significant（ P〈0. 05）,the mortality rate of study were remarkably reduced compared with the control group,the difference was statistically significant（ P〈0. 05）. While the hepatic and renal function had no significantly difference between the two groups（ P〉0. 05）. Conclusion High-dose ambroxol is efficient and safe for severe pneumonias in eldly patients.