布地奈德与复方异丙托溴铵联合雾化治疗慢阻肺急性加重期患者的疗效分析

Analysis of the efficacy of budesonide combined with compound ipratropium bromide aerosol inhalation for patients with acute exacerbation of chronic obstructive pulmonary disease

目的 分析布地奈德与复方异丙托溴铵联合雾化治疗慢性阻塞性肺疾病(慢阻肺)急性加重期患者的疗效。方法 120例慢阻肺急性加重期患者,通过随机动态数字表分为对照组及观察组,每组60例。对照组采用布地奈德雾化吸入治疗,观察组采用布地奈德联合复方异丙托溴铵雾化吸入治疗。比较两组患者治疗前后血气分析指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO_(2))]、炎症介质指标[降钙素原(PCT)、C反应蛋白(CRP)]、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]水平,临床治疗效果,不良反应发生率。结果 治疗后,观察组患者的PaO2(78.29±4.52)mm Hg(1 mm Hg=0.133 kPa)高于对照组的(66.04±4.15)mm Hg, PaCO_(2)(47.97±5.93)mm Hg低于对照组的(53.26±5.61)mm Hg,差异具有统计学意义(P<0.05)。治疗后,观察组患者的PCT(0.43±0.09)ng/ml、CRP(10.23±1.02)mg/L低于对照组的(0.65±0.16)ng/ml、(12.28±1.75)mg/L,差异具有统计学意义(P<0.05)。治疗后,观察组患者的FEV1(2.42±0.79)L、FVC(3.43±0.95)L、FEV1/FVC(70.55±14.73)%均高于对照组的(1.91±0.58)L、(3.01±0.89)L、(63.46±13.14)%,差异具有统计学意义(P<0.05)。观察组治疗总有效率96.67%高于对照组的78.33%,差异具有统计学意义(P<0.05)。观察组不良反应发生率10.00%与对照组的8.33%比较,差异无统计学意义(P>0.05)。结论 布地奈德与复方异丙托溴铵联合雾化治疗慢阻肺急性加重期可以有效改善患者的血气分析指标,缓解炎症介质,有利于强化患者的肺功能,缓解呼吸困难等症状,且不易出现不良反应,安全性较好。

Objective To analyze the efficacy of budesonide combined with compound ipratropium bromide aerosol inhalation for patients with acute exacerbation of chronic obstructive pulmonary disease. Methods A total of 120 patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into control group and observation group according to random dynamic numerical table, with 60 patients in each group. The control group was treated by budesonide aerosol inhalation, while the observation group was treated by budesonide combined with compound ipratropium bromide aerosol inhalation. Both groups were compared in terms of levels of blood gas analysis indicators [arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2)], inflammatory mediator indicators [procalcitonin(PCT), C-reactive protein(CRP)], pulmonary function indicators [forced expiratory volume in one second(FEV1), forced vital capacity(FVC), FEV1/FVC] before and after treatment, clinical effect, and occurrence of adverse reactions. Results After treatment, the PaO2(78.29±4.52) mm Hg(1 mm Hg=0.133 kPa) in the observation group was higher than(66.04±4.15) mm Hg in the control group, and the PaCO2(47.97±5.93) mm Hg was lower than(53.26±5.61) mm Hg in the control group, and the differences were statistically significant(P<0.05). After treatment, the PCT(0.43±0.09) ng/ml and CRP(10.23±1.02) mg/L in the observation group were significantly lower than(0.65±0.16) ng/ml and(12.28±1.75) mg/L in the control group, and the difference was statistically significant(P<0.05). After treatment, the FEV1(2.42±0.79) L, FVC(3.43±0.95) L and FEV1/FVC(70.55±14.73)% in the observation group were higher than(1.91±0.58) L,(3.01±0.89) L and(63.46±13.14)% in the control group, and the differences were statistically significant(P<0.05). The total effective rate of treatment in the observation group was 96.67%, which was higher than 78.33% in the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group was 10.00%, and the difference was not statistically significant compared with 8.33% in the control group(P>0.05). Conclusion The budesonide combined with compound ipratropium bromide aerosol inhalation for the treatment of acute exacerbation of chronic obstructive pulmonary disease can effectively improve patients’ blood gas analysis index, alleviate inflammatory mediators, and strengthen patients’ lung function and relieve symptom of dyspnea. It is less prone to adverse reactions, and has high safety.