多索茶碱联合雾化吸入布地奈德、异丙托溴铵治疗慢性阻塞性肺疾病急性加重患者疗效研究

Efficacy of doxofylline combined with aerosol inhalation of budesonide and ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨多索茶碱联合雾化吸入布地奈德、异丙托溴铵治疗慢性阻塞性肺疾病急性加重(AECOPD)患者的临床疗效,观察其对血气指标及血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平的影响。方法选取自2019年4月至2022年4月收治的60例AECOPD患者为研究对象,采用随机数字表法将患者分为A组(n=30)与B组(n=30)。A组给予多索茶碱治疗,B组给予多索茶碱联合雾化吸入布地奈德、异丙托溴铵治疗。记录并比较两组患者治疗前、后肺功能指标[1 s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]、氧合指数(OI)、血清PCT、hs-CRP水平及慢性阻塞性肺疾病评估测试(CAT)评分。记录并比较两组患者不良反应发生情况。结果治疗后,两组患者FEV1、FVC、FEV1/FVC高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。治疗后,两组患者OI高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。治疗后,两组患者PCT、hs-CRP较治疗前降低,且B组低于A组,差异有统计学意义(P<0.05)。治疗后,两组患者CAT评分较治疗前降低,且B组低于A组,差异有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论多索茶碱联合雾化吸入布地奈德、异丙托溴铵治疗AECOPD能有效降低患者炎症反应,提高肺功能,更好改善其血气指标,且安全性好。

Objective To investigate the clinical efficacy of doxofylline combined with aerosol inhalation of budesonide and ipratropium bromide in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to observe its effects on blood gas indexes and levels of serum procalcitonin(PCT)and high-sensitive C-reactive protein(hs-CRP).Methods A total of 60 patients with AECOPD admitted from April 2019 to April 2022 were selected and divided into group A(n=30)and group B(n=30)by random number table method.The patients in group A were treated with doxofylline,and the patients in group B were treated with doxofylline combined with aerosol inhalation of budesonide and ipratropium bromide.The pulmonary function indexes[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC],oxygenation index(OI),serum PCT,serum hs-CRP,and chronic obstructive pulmonary disease assessment test(CAT)scores were recorded and compared between the two groups before and after the treatment.The incidence of adverse reactions was recorded and compared between the two groups.Results After the treatment,FEV1,FVC and FEV1/FVC of the two groups were higher than those before the treatment,and those of group B were higher than those of group A,and the differences were statistically significant(P<0.05).After the treatment,the OI of the two groups was higher than that before the treatment,and the OI of group B was higher than that of group A,and the difference was statistically significant(P<0.05).After the treatment,PCT and hs-CRP of the two groups were lower than those before the treatment,and those of group B were lower than those of group A,and the differences were statistically significant(P<0.05).After the treatment,the CAT score of the two groups was lower than that before the treatment,and the CAT score of group B was lower than that of group A,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions Doxofylline combined with aerosol inhalation of budesonide and ipratropium bromide in the treatment of AECOPD can effectively reduce the inflammatory response,improve lung function and blood gas indexes,and it has good safety.