乙酰半胱氨酸雾化吸入联合脾多肽治疗老年重症肺部感染对血清游离促肾上腺皮质激素、皮质醇水平的影响

Effects of acetylcysteine aerosol inhalation combined with splenic polypeptide on the level of free cortisol and adrenocortictrophic hormone in elderly patients with severe lung infection

目的分析乙酰半胱氨酸雾化吸入联合脾多肽治疗老年重症肺部感染病人的效果及对血清游离皮质醇(COR)、促肾上腺皮质激素(ACTH)水平的影响。方法选择2018年3月至2019年4月在本院接受治疗的老年重症肺部感染病人86例,根据入院时间随机分为对照组和观察组。对照组病人在常规治疗的基础上给予乙酰半胱氨酸雾化吸入治疗,观察组病人在对照组治疗措施的基础上静脉滴注脾多肽注射液,比较2组病人临床疗效,血清游离COR、ACTH水平,呼吸动力学指标。结果观察组病人有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组病人血PaO_(2)、氧合指数均显著高于对照组,PaCO_(2)低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组病人血清游离COR、ACTH水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组发热、咳嗽、气促、肺部湿啰音等临床症状改善时间明显早于对照组,机械通气时间明显短于对照组,差异均有统计学意义(P<0.05)。结论乙酰半胱氨酸雾化吸入联合脾多肽可有效改善老年重症肺部感染病人临床症状,降低病人血清游离COR、ACTH水平,具有较好的临床应用前景。

Objective To analyze the effects of acetylcysteine atomization inhalation combined with spleen polypeptide on the serum levels of free cortisol(COR)and adrenocorticotrophic hormone(ACTH)in the elderly patients with severe pulmonary infection,and to analyze the efficacy.Methods A total of 86 elderly patients with severe pulmonary infection were selected from March 2018 to April 2019.All cases were randomly divided into the control group and the observation group according to the admission time.Patients in the control group were treated with acetylcysteine inhalation on the basis of routine treatment.Patients in the observation group received intravenous drip of spleen polypeptide on the basis of the control group.The clinical efficacy,the serum levels of free COR,ACTH and respiratory dynamics were compared between the two groups.Results The effective rate in the observation group was significantly higher than that in the control group(P<0.05).After treatment,and the levels of arterial partial pressure of oxygen(PaO_(2))and oxygenation index in the observation group were significantly higher,and the level of arterial partial pressure of carbon dioxide(PaCO_(2))was significantly lower than that in the control group(P<0.05).After treatment,the serum levels of free COR,ACTH in the observation group were significantly lower than those in the control group(P<0.05).The clinical symptoms of fever,cough,shortness of breath and moist rales of the lungs in the observation group were improved significantly earlier than those in the control group(P<0.05),and the mechanical ventilation time was significantly shortter than that of the control group(P<0.05).Conclusions Acetylcysteine atomization inhalation combined with spleen polypeptide can effectively improve the clinical symptoms,decrease the serum levels of free COR and ACTH in the elderly patients with severe pulmonary infection.It has a good clinical application prospect.