阿奇霉素联合纤支镜肺泡灌洗治疗支气管扩张症的临床效果及对肺功能的影响

Clinical effect of Azithromycin combined with bronchoscopy alveolar lavage in the treatment of bronchiectasis and its influence on lung function

目的探讨阿奇霉素联合(BAL)治疗支气管扩张症(BE)的临床效果及对肺功能的影响。方法选取2018年6月—2020年6月麻城市人民医院收治的84例BE患者作为研究对象,采用随机数字表法将其分为对照组(42例)和观察组(42例)。对照组患者予以阿奇霉素治疗,观察组患者加用BAL治疗。比较两组患者的临床疗效、肺功能指标、炎症因子水平和不良反应发生率。结果观察组患者的治疗总有效率(95.24%)高于对照组(80.95%),差异有统计学意义(P<0.05)。治疗前,两组患者的肺功能、炎症因子水平比较,差异无统计学意义(P>0.05);两组患者治疗后的用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC均高于同组治疗前,且观察组患者治疗后的FVC、FEV1、FEV1/FVC均高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)水平低于同组治疗前,且观察组患者治疗后的WBC、hs-CRP水平低于对照组,差异有统计学意义(P<0.05);两组均未发生严重不良反应。结论阿奇霉素联合BAL可增强BE患者的治疗效果,减轻机体的炎症反应,加快患者的肺功能恢复,安全可靠,值得临床推广应用。

Objective To investigate the clinical effect of Azithromycin combined with bronchoscopy alveolar lavage(BAL)in the treatment of bronchiectasis(BE)and its influence on lung function.Methods A total of 84 BE patients with admitted to Machang People′s Hospital from June 2018 to June 2020 were selected as subjects and divided into control group(42 cases)and observation group(42 cases)by random number table method.The control group was treated with Azithromycin,and the observation group was additively treated with BAL.The clinical efficacy,pulmonary function indexes,inflammation levels and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group(95.24%)was higher than that in the control group(80.95%),and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in lung function and inflammatory factor levels between the two groups(P>0.05).After treatment,forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and FEV1/FVC in the two groups were all higher than those before treatment,and FVC,FEV1 and FEV1/FVC in observation group were all higher than those in control group,with statistically significant differences(P<0.05).The white blood cell count(WBC)and high-sensitivity C-reactive protein(hs-CRP)levels in the two groups after treatment were lower than those before treatment,and the WBC and hs-CRP levels in observation group after treatment were lower than those in control group,with statistically significant differences(P<0.05).No serious adverse reactions occurred in the two groups.Conclusion Azithromycin combined with BAL can enhance the therapeutic effect of BE patients,reduce the body′s inflammatory response,accelerate the recovery of lung function in patients,safe and reliable,worthy of clinical application。