盐酸氨溴索治疗疗程对老年慢性阻塞性肺疾病急性发作的影响

Clinical effects of different courses of ambroxol on elderly patients with acute exacerbation of chronic obstructive pulmonary disease

目的对比不同疗程使用盐酸氨溴索治疗老年慢性阻塞性肺疾病急性发作(AECOPD)的疗效及其对炎症反应的影响。方法选取2014年1月到2016年12月期间收治的126例老年AECOPD的病人,随机分为A组和B组各63例。A组连续静脉推注盐酸氨溴索(120 mg/d)1周,B组连续静脉推注2周。对比2组病人的临床疗效以及治疗前后的动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、改良版英国医学研究会呼吸困难量表评分(mMRC评分)、血清白细胞介素(IL-8)、肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)以及中性粒细胞计数(NC)的水平。结果 B组显效率为90.48%,总有效率为96.83%,均显著高于A组(均P<0.05);B组治疗后的Pa O2显著高于A组,而Pa CO2、mMRC评分显著低于A组(均P<0.05);B组治疗后的IL-8、TNF-α、hs-CRP、WBC、NC均显著低于A组(均P<0.05)。结论延长盐酸氨溴索的疗程可显著减轻老年AECOPD病人的炎症反应损伤,提高AECOPD的临床治疗效果。

Objective To compare the effect of different courses of ambroxol on elderly patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） and its effect on inflammatory response.Methods A total of 126 elderly patients with AECOPD from January 2014 to December 2016 were selected and randomly divided into group A and group B,with 63 cases in each group.Group A was treated with continuous intravenous injection of ambroxol（ 120 mg/d） for 1 week,while group B was treated for 2 weeks.The clinical efficacy of two groups were compared.The levels of arterial oxygen pressure（ PaO_2）,partial pressure of carbon dioxide in artery（ PaCO_2）,m MRC score,interleukin（ IL）-8,tumor necrosis factor（ TNF）-α,high sensitivity C-reactive protein（ hs-CRP）,WBC and NC were compared between two groups before and after the treatment.Results The effective rate and the total effective rate of group B was 90.48%,96.83% respectively,which were significantly higher than those in group A（ P〈0.05）.After treatment,the levels of Pa O2 of group B were significantly higher than those in group A,while the levels of PaCO_2,mMRC score were significantly lower than those in group A（ P 〈0.05）.After treatment,the levels of IL-8,TNF-α,hs-CRP,WBC,and NC were significantly lower than those in group A（ P〈0.05）.Conclusions The prolonged course of treatment of ambroxol can significantly reduce the inflammatory response damage in elderly patients with AECOPD,and improve its clinical efficacy.