噻托溴铵联合头孢哌酮钠舒巴坦钠治疗慢性阻塞性肺疾病的疗效及安全性

Efficacy and safety of tiotropium bromide combined with cefoperazone sodium and sulbactam sodium in the treatment of chronic obstructive pulmonary disease

目的观察噻托溴铵联合头孢哌酮钠舒巴坦钠治疗慢性阻塞性肺疾病(COPD)的临床疗效及安全性。方法选取2018年1月—2019年12月湖北省红安县人民医院收治的COPD患者122例,按照随机数字表法分为观察组与对照组各61例。对照组患者采用头孢哌酮钠舒巴坦钠治疗,观察组患者采用噻托溴铵联合头孢哌酮钠舒巴坦钠治疗,2组疗程均为30 d。比较2组患者的临床疗效、临床症状改善时间,治疗前后肺功能、血气分析指标、炎性因子、COPD评估测试(CAT)评分、改良版的英国MRC呼吸困难(mMRC)评分及不良反应。结果观察组患者的治疗总有效率为88.52%,高于对照组的67.21%(χ^(2)=8.038,P=0.005)。观察组患者的发热消失时间、咯痰消失时间、咳嗽消失时间及胸部CT恢复正常时间均短于对照组(P<0.01)。治疗30 d后,2组患者的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及FEV_(1)/FVC均高于治疗前,且观察组患者均高于对照组(P<0.01);2组患者的动脉二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO2)及pH值均优于治疗前,且观察组均优于对照组(P<0.05)。2组患者的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及降钙素原(PCT)均低于治疗前,且观察组均低于对照组(P<0.01);2组患者的CAT评分及mMRC评分均低于治疗前,且观察组均低于对照组(P<0.05)。观察组和对照组患者不良反应总发生率均为3.28%,组间比较差异无统计学意义(P>0.05)。结论噻托溴铵联合头孢哌酮钠舒巴坦钠治疗COPD的效果确切,患者病情显著缓解,呼吸及肺功能改善,且治疗安全性高,起效快,在临床中可推广使用。

Objective To observe the clinical efficacy and safety of tiotropium bromide combined with cefoperazone sodium and sulbactam sodium in the treatment of chronic obstructive pulmonary disease(COPD).Methods A total of 122 COPD patients admitted to People′s Hospital of Hong′an County,Hubei Province from January 2018 to December 2019 were selected,according to the random number table method,they were divided into observation group and control group,61 cases in each group.The control group was treated with cefoperazone sodium and sulbactam sodium,while the observation group was treated with tiotropium bromide combined with cefoperazone sodium and sulbactam sodium,the course of treatment in both groups was 30 days.The clinical efficacy,improvement time of clinical symptoms,pulmonary function,blood gas analysis index,inflammatory factors,COPD assessment test(CAT)score,modified british MRC dyspnea(mMRC)score and adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 88.52%,which was higher than 67.21%of the control group(χ^(2)=8.038,P=0.005).The fever disappearance time,sputum disappearance time,cough disappearance time and chest CT recovery time of the observation group were shorter than those of the control group(P<0.01).After 30 days of treatment,the forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC of the two groups were higher than those before treatment,and the observation group were higher than those of the control group(P<0.01).The arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO2)and pH of the two groups were better than those before treatment,and the observation group was better than the control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α),C-reactive protei(CRP)and procalcitonin(PCT)in the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.01).The CAT score and mMRC score of the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The total incidence of adverse reactions in the observation group and the control group was 3.28%,and there was no significant difference between the two groups(P>0.05).Conclusion Tiotropium bromide combined with cefoperazone sodium and sulbactam sodium in the treatment of COPD has a definite effect,the patient′s condition is significantly relieved,respiratory and pulmonary function are improved,and effective quickly and the treatment is safe,so it can be popularized in clinical practice.