依替米星联合支气管肺泡灌洗治疗支气管扩张合并慢性阻塞性肺疾病患者的临床效果

Clinical research of etimicin combined with bronchoalveolar lavage on patients with bronchiectasis complicated with chronic obstructive pulmonary disease

目的探讨依替米星联合支气管肺泡灌洗治疗支气管扩张合并慢性阻塞性肺疾病的临床疗效。方法选取2018年1月至2020年1月惠州市中心人民医院博罗分院收治的72例支气管扩张合并慢性阻塞性肺疾病患者,随机分为观察组和对照组,每组各36例。两组患者均给予常规治疗,对照组加用支气管肺泡灌洗,观察组同时局部应用依替米星。比较两组患者的临床疗效、治疗前后的肺功能检查以及感染相关指标的检查结果、两组患者的不良反应发生情况。结果观察组的显效率为63.89%,总有效率为97.22%,显著高于对照组;观察组治疗后的肺活量(VC)为(3.21±0.73)L,第一秒用力呼气容积(FEV1)为(1.81±0.43)L,第一秒用力呼气量占用力肺活量比值(FEV1/FVC)为(67.03±11.36)%,均显著高于治疗前和对照组;观察组治疗后的入院白细胞计数(WBC)、中性粒细胞百分比(N%)、超敏C反应蛋白(hsCRP)、降钙素原(PCT)均显著低于治疗前和对照组,差异均有统计学意义(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P<0.05)。结论依替米星联合支气管肺泡灌洗可提高支气管扩张合并慢性阻塞性肺疾病的抗感染效果和改善患者的肺功能,显著提高临床疗效,且具有良好的安全性。

Objective To investigate the clinical efficacy of etimicin combined with bronchoalveolar lavage on patients with bronchiectasis complicated with chronic obstructive pulmonary disease(COPD).Methods A total of 72 patients with bronchiectasis complicated with COPD admitted to Boluo Branch of Huizhou Municipal Central Hospital from January 2018 to January 2020 were randomly divided into the observation group(n=36)and the control group(n=36).Both groups of patients were given conventional treatment.On the above basis,the control group was combined with bronchoalveolar lavage,while the observation group was combined with etimicin locally at the same time.The clinical efficacy,pulmonary function examination before and after treatment,the examination results of infection-related indexes and the incidence of adverse reactions(ADRs)of the two groups of patients were compared.Results The obvious efficacy rate of the observation group was 63.89%,and the total efficacy rate was 97.22%,which were significantly higher than those of the control group.In the observation group,after treatment,the vital capacity(VC)was(3.21±0.73)L,the forced expiratory volume in the first second(FEV1)(1.81±0.43)L,and the ratio of FEV1 to the forced VC(FEV1/FVC)(67.03±11.36)%,which were all significantly higher than those before and after treatment.The white blood cell count(WBC),neutrophil percentage(N%),high-sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT)in the observation group after treatment were all significantly lower than those in the control group before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Etimicin combined with bronchoalveolar lavage can increase the anti-infection efficacy of bronchiectasis complicated with COPD,improve the pulmonary function of patients,significantly raise the clinical efficacy and have good medication safety.