头孢呋辛联合甲泼尼龙治疗老年慢性阻塞性肺疾病合并肺气肿的疗效观察

Observation of the effect of cefuroxime combined with methylprednisolone in the treatment of chronic obstructive pulmonary disease with emphysema

目的 观察老年慢性阻塞性肺疾病（COPD）合并肺气肿患者接受头孢呋辛联合甲泼尼龙治疗的疗效.方法 选取92例老年慢性阻塞性肺气肿患者为研究对象,按照数字表法随机分为观察组和对照组,每组46例.对照组采用抗生素治疗,观察组采用头孢呋辛联合甲泼尼龙治疗,比较两组临床治疗效果、肺功能指标、血气指标及不良反应发生情况.结果 观察组总有效率为91.30%,明显高于对照组的76.09%（χ^2=8.476,P〈0.05）;观察组用力肺活量占预计值百分比（FVC%）、第一秒钟用力呼气容积（FEV1）、第一秒用力呼气容积占预计值百分比（FEV1%）、最大分钟通气量（MVV）均高于对照组（t=2.657、3.610、2.413、2.359,均P〈0.05）;观察组PaO2水平[（80.3±2.8）mmHg]较对照组[（74.1±3.8）mmHg]更高,PaCO2水平[（34.0±1.1）mmHg]明显低于对照组[（40.2±2.2）mmHg],差异均有统计学意义（t=3.021 1、3.952,均P〈0.05）;观察组不良反应发生率为6.52%,与对照组的10.87%比较差异无统计学意义（χ^2=1.363,P〉0.05）.结论 针对老年慢性阻塞性肺疾病合并肺气肿患者,采用抗生素与糖皮质激素联合治疗,可有效缓解临床症状,改善血气指标和肺功能,不良反应少,安全性高,具有较高的临床应用价值.

Objective To observe and analyze the clinical effect of cefuroxime combined with methylprednisolone in the treatment of elderly patients with chronic obstructive pulmonary disease（COPD） complicated with pulmonary emphysema.Methods 92 COPD patients complicated with pulmonary emphysema were selected as study objects,and they were randomly divided into observation group and control group.46 cases in the control group were treated with antibiotic treatment, and 46 cases in the observation group were treated with cefuroxime combined with methylprednisolone.The clinical curative effect, pulmonary function, blood gas index and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 91.30%, which was significantly higher than 76.09% of the control group （χ^2=8.476,P〈0.05）.The pulmonary function indices including FVC%,FEV1,FEV1%,MVV levels in the observation group were higher than those in the control group （t=2.657,3.610,2.413,2.359,all P〈0.05）.The PaO2 level in the observation group [（80.3±2.8）mmHg] was higher than （74.1±3.8）mmHg in the control group, the PaCO2 level in the observation group [（34.0±1.1）mmHg] was significantly lower than （40.2±2.2）mmHg in the control group, the differences were statistically significant （t=3.021,3.952,all P〈0.05）.The incidence rate of adverse reactions of the observation group was 6.52%,which of the control group was 10.87%, the difference was not significant （χ^2=1.363,P〉0.05）.Conclusion In elderly COPD patients with emphysema, using cefuroxime combined with methylprednisolone therapy can effectively alleviate the clinical symptoms, improve lung function and blood gas index, and has less adverse reactions, higher safety and high clinical application value.