氨溴索联合布地奈德福莫特罗治疗重度慢阻肺合并肥胖型OSAHS的临床效果分析

Clinical effect analysis of ambroxol combined with budesonide/formoterol in the treatment of severe chronic obstructive pulmonary disease combined with obese OSAHS

目的 探究布地奈德福莫特罗与氨溴索联合治疗重度慢性阻塞性肺疾病(慢阻肺)合并肥胖型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床疗效。方法 72例重度慢阻肺合并肥胖型OSAHS患者,以数字号(1~72)形式随机分为对照组及观察组,各36例。对照组患者行布地奈德福莫特罗治疗,观察组患者行布地奈德福莫特罗联合氨溴索治疗。对比两组患者不良反应发生率及血生化指标[C反应蛋白(CRP)、D-二聚体(D-D)和可溶性白细胞介素-2受体(SIL-2R)]、肺功能指标[第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)、第1秒用力呼气容积(FEV1)和最大呼气中段流量]水平。结果 治疗后,两组CRP、D-D、SIL-2R水平均低于本组治疗前,且观察组CRP(14.72±1.50)mg/L、D-D(0.57±0.07)mg/L、SIL-2R(404.34±23.74)U/ml低于对照组的(17.51±2.33)mg/L、(0.63±0.08)mg/L、(451.15±29.70)U/ml,差异具有统计学意义(P<0.05)。治疗后,两组FEV1/FVC、FEV1、最大呼气中段流量均高于本组治疗前,且观察组FEV1/FVC(66.17±3.30)%、FEV1(1.77±0.19)L、最大呼气中段流量(4.30±0.45)L/s高于对照组的(55.15±2.39)%、(1.68±0.14)L、(4.04±0.51)L/s,差异具有统计学意义(P<0.05)。观察组不良反应发生率为19.44%,与对照组的16.67%对比,差异无统计学意义(P>0.05)。结论 对重度慢阻肺合并肥胖型OSAHS患者行布地奈德福莫特罗与氨溴索联合治疗效果佳,有助于患者病情缓解,达到炎症、肺功能指标的改善。

Objective To investigate the clinical efficacy of ambroxol combined with budesonide/formoterol in the treatment of severe chronic obstructive pulmonary disease combined with obese obstructive sleep apnea hypopnea syndrome(OSAHS). Methods A total of 72 patients with severe chronic obstructive pulmonary disease and obese OSAHS were randomly divided into a control group and an observation group according to numerical number(1-72), with 36 patients in each group. Patients in the control group were treated with budesonide/formoterol, and patients in the observation group were treated with budesonide/formoterol combined with ambroxol. Both groups were compared in terms of incidence of adverse reactions and the levels of blood biochemical indexes [C-reactive protein(CRP), D-dimer(D-D) and soluble interleukin-2 receptor(SIL-2R)], pulmonary function indexes [forced expiratory volume in one second/forced vital capacity(FEV1/FVC), forced expiratory volume in one second(FEV1) and maximum mid-expiratory flow]. Results After treatment, the CRP, D-D, and SIL-2R levels in both groups were lower than those before treatment in this group;the CRP(14.72±1.50) mg/L, D-D(0.57±0.07) mg/L, SIL-2R(404.34±23.74) U/ml in the observation group were lower than(17.51±2.33) mg/L,(0.63±0.08) mg/L,(451.15±29.70) U/ml in the control group;the differences were statistically significant(P<0.05). After treatment, the FEV1/FVC, FEV1, and maximum midexpiratory flow in both groups were higher than those before treatment in this group;the FEV1/FVC(66.17±3.30)%,FEV1(1.77±0.19)L, and maximum mid-expiratory flow(4.30±0.45) L/s in the observation group were higher than(55.15±2.39)%,(1.68±0.14) L, and(4.04±0.51) L/s in the control group;the differences were statistically significant(P<0.05). The incidence of adverse reactions in the observation group was 19.44%, which had no statistically significant difference compared with 16.67% in the control group(P>0.05). Conclusion Co-treatment of budesonide/formoterol and ambroxol for patients with severe chronic obstructive pulmonary disease and obese OSAHS has a good effect, and can alleviate patient’s condition, and improve their inflammation and lung function indicators.