雾化特布他林联合布地奈德治疗急性加重期慢性阻塞性肺疾病的临床疗效及对炎性因子的影响

Clinical efficacy of nebulized butaline combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease and its effect on inflammatory factors

目的研究雾化特布他林联合布地奈德治疗急性加重期慢性阻塞性肺疾病(AECOPO)的临床疗效及对炎性因子的影响。方法选择2017年1月至2018年6月在我院治疗的AECOPD患者108例,用随机数字表法分为对照组54例和观察组54例。对照组给予常规治疗,观察组加用特布他林联合布地奈德雾化吸入治疗。比较2组患者的临床疗效、肺功能指标、血气指标和炎性因子水平。结果观察组显效38例(70%),有效14例(26%),总有效率为96%,对照组仅为83%(P<0.05)。治疗前2组患者的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气中期流速(MMEF)和最大呼气流速(PEF)水平相近(P>0.05),治疗后2组患者的肺功能指标明显改善,观察组患者的FEV1、FVC、MMEF和PEF水平高于对照组(P<0.05)。治疗前2组患者的动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)水平相近(P>0.05),治疗后2组患者的血气指标明显改善,观察组患者的PaO2水平高于对照组,PaCO2水平低于对照组(P<0.05)。治疗后观察组的白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α和超敏C反应蛋白(hs-CRP)水平较低(P<0.05)。结论特布他林联合布地奈德雾化吸入治疗能够明显提高AECOPD患者的临床疗效,改善肺功能和血气指标,减轻炎性反应,值得在临床推广应用。

Objective To study the clinical efficacy of nebulized butaline combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on inflammatory factors. Methods From January 2017 to June 2018, 108 patients with AECOPD who were treated in our hospital were selected and divided into control group (n=54) and observation group (n=54) by random number table method. The control group was given routine treatment, while the observation group was treated with terbutaline combined with budesonide aerosol inhalation. The clinical efficacy, pulmonary function, blood gas and inflammatory factors were compared between the two groups. Results Thirty-eight cases (70%) were markedly effective and 14 cases (26%) were effective in the observation group, and the total effective rate was 96%, and 83% in the control group (P<0.05). Before treatment, the levels of FEV1, FVC, MMEF and PEF in the two groups were similar (P>0.05). After treatment, the lung function indexes of the two groups were significantly improved. The levels of FEV1, FVC, MMEF and PEF in the observation group were higher than those in the control group (P<0.05). Before treatment, the PaO2 and PaCO2 levels of the two groups were similar (P>0.05). After treatment, the blood gas indexes of the two groups were significantly improved. The PaO2 level of the observation group was higher than that of the control group, and the PaCO2 level was lower than that of the control group (P<0.05). After treatment, the levels of IL-6, IL-8, TNF-α and hs-CRP in the observation group were lower than those in the control group (P<0.05). Conclusion Terbutaline combined with budesonide aerosol inhalation therapy can significantly improve the clinical efficacy of AECOPD patients, improve pulmonary function and blood gas index, reduce inflammatory reaction, and is worthy of clinical application.