低剂量阿奇霉素联合沙美特罗替卡松和噻托溴铵治疗老年慢性阻塞性肺疾病患者的临床效果

Clinical effect of low dose azithromycin combined with salmeterol fluticasone and tiotropium bromide in the treatment of elderly patients with chronic obstructive pulmonary disease

目的探讨低剂量阿奇霉素联合沙美特罗替卡松和噻托溴铵治疗老年慢性阻塞性肺疾病(COPD)患者的临床效果。方法将本院2018年1月至2020年1月收治的80例COPD患者随机分为对照组和观察组,每组40例。对照组给予噻托溴铵治疗,观察组在对照组的基础上给予低剂量阿奇霉素和沙美特罗替卡松治疗。比较两组的肺功能、氧化应激、免疫功能指标。结果治疗后,两组的FVC、FEV1、IC、FEV1/FVC均较治疗前升高,且观察组高于对照组(P<0.05)。治疗后,观察组的OX-LDL与MDA水平均低于对照组,SOD与TAC水平均高于对照组(P<0.05)。治疗后,两组的CD3^(+)、CD4^(+)均升高,CD8^(+)均降低,且观察组优于对照组(P<0.05)。结论低剂量阿奇霉素联合沙美特罗替卡松和噻托溴铵治疗老年COPD患者,可显著改善患者的肺功能及免疫功能,减轻氧化应激反应。

Objective To investigate the clinical effect of low dose azithromycin combined with salmeterol fluticasone and tiotropium bromide in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD).Methods Eighty cases of COPD patients treated in our hospital from January 2018 to January 2020 were randomly divided into control group and observation group,with 40 cases in each group.The control group was given tiotropium bromide treatment,and the observation group was given low dose azithromycin and salmeterol fluticasone treatment on the basis of the control group.The indexes of lung function,oxidative stress and immune function were compared between the two groups.Results After treatment,the FVC,FEV1,IC and FEV1/FVC of the two groups were higher than those before treatment,and those of the observation group were higher than the control group(P<0.05).After treatment,the levels of OX-LDL and MDA in the observation group were lower than those in the control group,while the levels of SOD and TAC were higer than those in the control group(P<0.05).After treatment,CD3^(+)and CD4^(+)of the two groups increased,CD8^(+)decreased,and those of the observation group were better than the control group(P<0.05).Conclusion Low dose azithromycin combined with salmeterol fluticasone and tiotropium bromide in the treatment of elderly patients with COPD can significantly improve the lung function and immune function,and reduce oxidative stress reaction.