多索茶碱联合头孢美唑治疗慢性阻塞性肺疾病合并感染患者的临床效果、安全性及预后观察

Observation of Clinical Effect,Safety and Prognosis of Doxofylline Combined with Cefmetazole in the Treatment of Patients with Chronic Obstructive Pulmonary Disease Complicated with Infection

目的:探讨多索茶碱联合头孢美唑对慢性阻塞性肺疾病(COPD)合并感染患者的治疗效果,并分析联合应用的安全性及预后。方法:选取2016年2月-2022年2月在乐平市人民医院住院治疗的250例COPD合并感染患者,随机分为观察组和对照组,各125例。两组均接受常规COPD治疗,对照组采用头孢美唑钠治疗,观察组在对照组基础上加用多索茶碱治疗。比较两组的疗效及预后,以及治疗前后两组的肺功能、炎症反应、免疫功能,记录两组治疗期间的不良反应。结果:观察组总有效率(92.80%)显著高于对照组(84.80%)(P<0.05);治疗后,观察组呼气流量峰值(PEF)、最大呼气中期流量(MMEF)、第1秒用力呼气量(FEV1)、用力肺活量(FVC)均显著高于对照组(P<0.05);治疗后,观察组肿瘤坏死因子-α(TNF-α)和血小板衍生生长因子(PDGF)、C反应蛋白(CRP)水平均显著低于对照组(P<0.05);两组治疗后CD4+、CD4+/CD8+均显著升高,CD8+均显著降低,观察组较对照组变化均更明显(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);治疗后观察组生理、社会关系、心理和自评总分均高于对照组(P<0.05)。结论:多索茶碱联合头孢美唑治疗COPD合并感染的效果显著,可提高肺功能和免疫功能,减轻炎症反应,不良反应低且预后良好,值得临床推荐。

Objective:To investigate the effect of Doxofylline combined with Cefmetazole in the treatment of patients with chronic obstructive pulmonary disease(COPD)complicated with infection,and analyze the safety and prognosis of the combined application.Method:A total of 250 inpatients with COPD complicated with infection from February 2016 to February 2022 in Leping People's Hospital were selected and randomly divided into an observation group and a control group,125 cases in each group.Both groups received routine COPD treatment.The control group was treated with Cefmetazole Sodium,and the observation group was additionally treated with Doxofylline on the basis of the control group.The curative effect and prognosis,the lung function,inflammatory reaction and immune function of the two groups before and after treatment were compared,and the adverse reactions during treatment of the two groups were recorded.Result:The total effective rate in the observation group(92.80%)was significantly higher than that in the control group(84.80%)(P<0.05).After treatment,the peak expiratory flow(PEF),maximal mid-expiratory flow(MMEF),forced expiratory volume in the first second(FEV1)and forced vital capacity(FVC)in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),platelet-derived growth factor(PDGF)and C reactive protein(CRP)in the observation group were significantly lower than those in the control group(P<0.05).After treatment,CD4+and CD4+/CD8+in the two groups increased significantly,while CD8+decreased significantly,and the changes in the observation group were more obvious than those in the control group(P<0.05).There was no significant difference in adverse reaction rate between the two groups(P>0.05).After treatment,the total scores of physiology,social relations,psychology and self-evaluation in the observation group were higher than those in the control group(P<0.05).Conclusion:Doxofylline combined with Cefmetazole has a significant effect in the treatment of COPD complicated with infection,which can improve lung function and immune function,reduce inflammatory response,with low adverse reactions and good prognosis.It is worthy of clinical recommendation.