硫酸沙丁胺醇与噻托溴铵联合治疗对AECOPD患者CysC、hs-CRP和PA的影响

Effect of combined therapy of albuterol sulfate and tiotropium on the levels of hs-CRP and CysC in AECOPD patients

目的:探讨硫酸沙丁胺醇与噻托溴铵联合治疗对慢性阻塞性肺疾病急性发作期(chronic obstructive pulmonary disease,AECOPD)患者血清胱抑素-C(CysC)与超敏C反应蛋白(hs-CRP)的影响。方法:选取自2013年1月至2014年1月我院收治的AECOPD患者80例,按随机数字表法将其分为对照组和观察组,每组40例。所有患者入院后均给予常规治疗,对照组患者在此基础上给予噻托溴铵治疗,观察组患者在对照组治疗基础上再给予硫酸沙丁胺醇治疗,两组患者均连续治疗7 d。分别于治疗前、治疗1周后检测两组患者血清中CysC、hs-CRP和PA水平情况,比较治疗前后两组患者的肺功能、血气分析指标变化情况。结果:治疗后两组血清CysC、hs-CRP水平较治疗前明显降低,PA水平较治疗前明显升高,尤以观察组升高或降低更为显著(P<0.05);观察组治疗后的肺功能指标如FEV1/FVC、FEV1/预计值分别为(71.52±8.25)%、(77.73±12.44)%,与对照组比较差异均有统计学意义(P<0.05);观察组治疗后的PaO_2水平为(65.23±2.04)mm Hg,明显高于对照组(P<0.05),而其他指标比较差异无有统计学意义(P>0.05)。结论:硫酸沙丁胺醇联合噻托溴铵治疗AECOPD的疗效显著优于单独应用噻托溴铵治疗,其不仅能提高肺功能,纠正低氧血症,还能有效改善血清中CysC、hs-CRP和PA水平,值得在临床上推广。

Objective： To investigate the impact of albuterol sulfate combined with tiotropium therapy on the levels of serum cystatin- C （ CysC ） and high- sensitivity C reactive protein （ hs - CRP） in patient with chronic obstructive pulmonary disease with acute exacerbation （AECOPD）. Methods： Eighty patients with AECOPD treated in our hospital from January 2013 to January 2014 were selected for this study. They were divided into control group and observation group by random number table method with 40 cases in each group. All the patients were given conventional treatment, and the control group was treated with tiotropium treatment on the basis of conventional treatment. In addition to the conventional and tiotropium treatment, the patients in the observation group received salbutamol sulphate. The patients were successively treated for 7d. The serum CysC, hs- CRP andPA levels in two groups were determined before and one week after the treatment. The pulmonary function and changes in blood gas analysis of the patients in the two groups were compared before and after the treatment. Results： After the treatment, the levels of CysC, hs-CRP and PA were changed significantly in both groups, and the CysC and hs-CRP levels were significantly decreased than those before the treatment, but the levels of PA were significantly higher than those before the treatment, especially in the observation group （P 〈 0. 05）. FEV1 / FVC and FEV1 / predicted value in the observation group were higher than those in the control group with statistical significance （ P 〈 0. 05 ）. After treatment Pa02 level was （65.23 ± 2.04 ） mmHg, which was significantly higher than that of the control group with statistical significance （ P 〈 0. 05 ）. No statistically significant difference was found between the two groups in other indicators （ P 〉 0. 05 ）. Conclusion： Combined therapy of albuterol sulfate and tiotropium has better effects than tiotropium alone, which can improve lung function and correct hypoxemia in AECOPD patients.