布地奈德联合盐酸氨溴索治疗对慢性阻塞性肺疾病患者外周血NLR、CRP水平与血气指标的影响

The effect of the therapy of budesonide combined with ambroxol hydrochloride on NLR,CRP levels and blood gas indexes in peripheral blood of patients with chronic obstructive pulmonary disease

目的探讨布地奈德联合氨溴索治疗对慢性阻塞性肺疾病(chronic obstructive pulmonary,COPD)患者中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(C reactive protein,CRP)水平及血气指标的影响。方法选取2017年1月~2018年12月呼吸内科因COPD收治住院的64例患者作为研究对象,并据随机数字表法分为研究组与对照组,各32例。对照组在常规治疗基础上给予布地奈德雾化吸入治疗,观察组在对照组基础上给予盐酸氨溴索静脉滴注治疗。比较两组疗效并观察治疗前后NLR、CRP、血气分析及症状改善时间等情况。结果经有效治疗后,研究组临床总有效率为87.50%,与对照组治疗总有效率(65.62%)相比,差异有统计学意义(P<0.05);治疗前,两组患者NLR、CRP、血气分析水平比较,差异无统计学意义(P>0.05);治疗后,两组患者NLR、CRP水平及动脉血二氧化碳分压(PaCO2)显著下降,pH值和动脉血氧分压(PaO2)水平均显著上升,且研究组与对照组相比,差异均有统计学意义(P<0.05);研究组气促、咳嗽、咳痰缓解时间较对照组显著下降,差异均有统计学意义(P均<0.05)。结论对COPD急性加重期患者应用布地奈德联合氨溴索治疗疗效显著,有助于减轻气道炎症反应,降低炎症指标水平,改善肺功能及动脉血气指标,改善临床症状,值得临床推广应用。

Objective To explore the effect of the therapy of budesonide combined with ambroxol hydrochloride on neutrophil/lymphocyte ratio(NLR),C reactive protein(CRP)levels and blood gas indexes of patients with chronic obstructive pulmonary disease(COPD).Methods 64 patients hospitalized for COPD in Department of Respiratory Medicine admitted to our hospital from January 2017 to December 2018 were selected as research subjects and divided into the study group and the control group through random number table method,with 32 patients in each group.The control group was treated with budesonide atomization inhalation on the basis of conventional treatment,while the observation group was treated with ambroxol hydrochloride intravenous drip on the basis of the control group.The efficacy was compared between the two groups and the conditions such as NLR,CRP,blood gas analysis and symptom improvement time before and after treatment were observed.Results After effective treatment,the total clinical effective rate in the study group was 87.50%,different from 65.62%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the analysis of NLR,CRP levels and results of blood gas between the two groups(P>0.05).After treatment,the NLR and CRP levels and level of partial pressure of carbon dioxide in artery(PaCO2)decreased significantly in the two groups,while the pH value and level of partial pressure of artery(PaO2)increased significantly,and the differences between the study group and the control group were statistically significant(P<0.05).The anhelous time,cough time and expectoration relief time in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Budesonide combined with ambroxol is significantly effective in treating patients with acute exacerbation of COPD,which is conducive to reducing airway inflammatory reaction,lowering inflammatory index level,improving pulmonary function and arterial blood gas index,and ameliorating clinical symptoms.It is worthy of clinical promotion.