糖皮质激素辅助治疗中老年慢性阻塞性肺气肿的效果及对肺功能的影响

Effect of glucocorticoid as an adjuvant therapy on treating middle-aged patients with chronic obstructive emphysema and influence on pulmonary function

目的探讨抗生素与糖皮质激素联用治疗中老年慢性阻塞性肺气肿的效果及对肺功能的影响。方法选取2012年1月~2015年8月我院92例中老年慢性阻塞性肺气肿患者,随机分为研究组和对照组,各46例。对照组采用单纯抗生素治疗,研究组在对照组的基础上联用糖皮质激素,使用SF-36量表评价生活质量,观察比较两组治疗总有效率、治疗前后肺功能指标变化情况及生活质量评分的差异。结果研究组患者的治疗总有效率明显较对照组高（P〈0.05）;治疗后研究组的肺活量、最大通气量较治疗前明显升高,优于对照组（P〈0.05）,研究组第一秒用力呼气容积占预计值百分比（FEV1%）、第一秒用力呼气容积与用力肺活量比值（FEV1/FVC%）较对照组显著下降（P〈0.05）;研究组患者SF-36各维度评分均较对照组优（P〈0.05）。结论抗生素与糖皮质激素联用治疗中老年慢性阻塞性肺气肿患者效果确切,能有效缓解组织缺氧状态,改善肺功能,提高患者的生活质量,值得临床推广。

Objective To explore effect of antibiotic combining with glucocorticoid on treating middle-aged patients with chronic obstructive emphysema（COE） and influences on pulmonary function. Methods From January 2012 to August 2015,92 middle-aged COE patients were selected and evenly divided into research group and control group in random.In the control group,only antibiotic was used,while in the research group,on the basis of the control group,glucocorticoid was combined.The SF-36 scale was used to evaluate the quality of life（QOL）.The total therapeutic effective rate,changes of pulmonary function before and after treatment,and score of QOL were observed and compared. Results In the research group,the total effective rate was higher than that in the control group（P0.05）.After treatment,vital capacity and maximal ventilatory volume（MVV） were both greatly improved in the research group in comparison with those in the control group（P0.05）.The percentage of forced expiratory volume in first second（FEV1%） and ratio of FEV in first second and forced vital capacity（FEV1/FVC%） in the research group were remarkably decreased in comparison with those in the control group（P 0.05）.The dimensional scores of SF-36 in the research group were better than those in the control group（P0.05）. Conclusion Combination of antibiotic and glucocorticoid can obtain a definite effect on treating middle-aged COE patients,and effectively relieve hypoxia,improve pulmonary function and patients′QOL,which is worthy of clinical promotion.