糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的临床疗效

Clinical effect of glucocorticoid combined with terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨糖皮质激素联合特布他林治疗慢性阻塞性肺疾病(慢阻肺)急性加重期的临床疗效。方法选取2018年2月至2020年5月本院收治的88例慢阻肺急性加重期患者作为研究对象,根据治疗方法不同分为观察组和对照组,每组44例。对照组给予特布他林雾化吸入治疗,观察组在对照组基础上给予小剂量甲强龙治疗。比较两组临床疗效、不良反应发生情况、动脉血气指标[二氧化碳分压(Pa-CO_(2))、血氧分压(PaO_(2))]、炎症因子[白细胞介素-21(IL-21)、TOLL样受体4(TLR4)]水平。结果观察组治疗总有效率为95.45%,高于对照组的77.27%,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。治疗后,两组PaCO_(2)、PaO_(2)水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-21、TLR4水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论特布他林联合糖皮质激素治疗慢阻肺急性加重期疗效显著,利于改善患者动脉血气指标,减轻炎症反应,且临床用药安全性较高,值得临床推广应用。

Objective To investigate the clinical effect of glucocorticoid combined with terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods 88 patients with acute exacerbation of COPD admitted to our hospital from February 2018 to May 2020 were selected as the research subjects,and they were divided into observation group and control group according to different of treatment methods,with 44 cases in each group.The control group was given atomized terbutaline inhalation treatment,and the observation group was given small dose of methylprednisolone treatment on the basis of the control group.The clinical efficacy,occurrence of adverse reactions,arterial blood gas indexes(partial pressure of carbon dioxide[PaCO_(2)],partial pressure of oxygen[PaO_(2)]),and levels of inflammatory factors(interleukin-21[IL-21],Toll-like receptor 4[TLR4])were compared between the two groups.Results The total effective rate of the observation group was 95.45%,which was higher than 77.27% of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.After treatment,PaCO_(2) and PaO_(2) levels of the two groups were higher than before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).After treatment,IL-21 and TLR4 levels in the two groups were lower than before treatment,and the observation group was lower than control group,the differences were statistically significant(P<0.05).Conclusion Terbutaline combined with glucocorticoid is effective in the treatment of acute exacerbation of COPD,which is conducive to improving arterial blood gas indexes,reducing inflammatory response,and has high clinical drug safety,which is worthy of clinical promotion and application.