不同剂量阿奇霉素维持治疗对预防稳定期非结核性支气管扩张症患者急性加重和对生命质量的影响

Effects of different doses of azithromycin maintenance therapy on the prevention of acute exacerbation and quality of life in patients with stable non tuberculous bronchiectasis

目的探讨不同剂量阿奇霉素维持治疗对预防稳定期非结核性支气管扩张症患者急性加重和对生命质量的影响。方法选取2019年6月至2021年6月本院收治的64例非结核性支气管扩张症患者作为研究对象,按照随机数字表法分为对照组与观察组,各32例。对照组采用阿奇霉素维持治疗,观察组采用阿奇霉素递减治疗,比较两组治疗期间急性加重次数、治疗前后T细胞亚群与生活质量。结果两组急性加重次数、呼吸困难评分差异无统计学意义;治疗后,两组CD4^(+)、CD4^(+)/CD8^(+)水平均高于治疗前,CD8^(+)水平低于治疗前,差异有统计学意义(P<0.05);两组治疗前后CD4^(+)、CD8^(+)与CD4^(+)/CD8^(+)水平比较差异无统计学意义;治疗后,两组躯体功能、躯体角色、心理健康及社会功能评分均高于治疗前(P<0.05),组间差异无统计学意义。结论阿奇霉素小剂量维持用药与递减用药均可预防稳定期非结核性支气管扩张症患者急性加重,改善患者机体免疫,提升其生命质量,递减治疗可减少用药量,具备更高的经济性。

Objective To investigate the effect of different doses of azithromycin maintenance therapy on preventing acute exacerbation and quality of life in patients with non tuberculous bronchiectasis at stable stage.Methods 64 patients with nontuberculous bronchiectasis admitted to our hospital from June 2019 to June 2021 were selected as the research subjects,and they were divided into control group and observation group according to random number table,with 32 cases in each group.The control group was treated with azithromycin,the observation group was treated with azithromycin,the times of acute exacerbation,T cell subsets and quality of life before and after treatment were compared between the two groups.Results There was no significant difference in the number of acute exacerbations and dyspnea scores between the two groups;After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in two groups were higher than those before treatment,the levels of CD8^(+)was lower than that before treatment,the difference was statistically significant(P<0.05);There was no significant difference in the levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups before and after treatment;After treatment,the scores of physical function,physical role,mental health and social function in two groups were higher than those before treatment(P<0.05),there was no significant difference between groups.Conclusion Both small dose maintenance and decreasing dosage of azithromycin can prevent the acute exacerbation of non tuberculous bronchiectasis patients in stable stage,improve the immunity of patients,improve their quality of life,decreasing treatment can reduce the dosage of drugs,with higher economy.