头孢哌酮舒巴坦联合特布他林对慢性阻塞性肺疾病合并肺部感染患者Th1/Th2因子水平的影响

Effect of cefoperazone sulbactam combined with terbutaline on Th1/Th2 factor level in chronic obstructive pulmonary disease patients complicated with pulmonary infection

目的探究头孢哌酮舒巴坦联合特布他林对慢性阻塞性肺疾病(COPD)合并肺部感染患者Th1/Th2因子水平的影响。方法选取2019年1月至2021年12月南昌市第三医院收治的60例COPD合并肺部感染患者作为研究对象,按照随机数字表法分为对照组与研究组,每组30例。对照组给予头孢哌酮舒巴坦治疗,研究组给予头孢哌酮舒巴坦联合特布他林雾化吸入治疗,比较两组Th1/Th2因子[干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、降钙素原(PCT)、C反应蛋白(CRP)、第1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC、凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FBG)及临床疗效。结果治疗后,两组TNF-α、IFN-γ水平均高于治疗前,IL-6、IL-10水平均低于治疗前,且研究组TNF-α、IFN-γ水平均高于对照组,IL-6、IL-10水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组PCT、CRP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组FVC、FEV1均大于治疗前,FEV1/FVC均高治疗前,且研究组FVC、FEV1均大于对照组,FEV1/FVC高于对照组,差异有统计学意义(P<0.05)。治疗后,两组FBG水平均低于治疗前,APTT、TT、PT均长于治疗前,且研究组FBG水平低于对照组,APTT、TT、PT均长于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率为96.67%,高于对照组的76.67%,差异有统计学意义(P<0.05)。结论特布他林联合头孢哌酮舒巴坦治疗COPD合并肺部感染患者疗效显著,可有效改善患者炎症指标、凝血指标、肺功能及Th1/Th2因子,值得临床推广应用。

Objective To explore the effect of cefoperazone sulbactam combined with terbutaline on Th1/Th2 factor level in patients with chron-ic obstructive pulmonary disease(COPD)complicated with pulmonary infection.Methods 60 patients with COPD complicated with pulmonary in-fection admitted to the Third Hospital of Nanchang City from January 2019 to December 2021 were selected as the research subject,and they were randomly divided into the control group and the research group according to the random number table method,with 30 cases in each group.The con-trol group was treated with cefoperazone sulbactam,and the study group was treated with cefoperazone sulbactam combined with terbutaline aerosol inhalation,Th1/Th2 factors(interferon-γ[IFN-γ],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6],interleukin-10[IL-10]),procalcitonin(PCT),C-reactive protein(CRP),forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC,activated partial thrombo-plastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FBG)and clinical efficacy were compared between the two groups.Results After treatment,the levels of TNF-αand IFN-γof the two groups were higher than those before treatment,the levels of IL-6 and IL-10 were lower than those before treatment,and the levels of TNF-αand IFN-γin the research group were higher than those in the control group,the levels of IL-6 and IL-10 were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the PCT and CRP levels of the two groups were lower than those before treatment,and the research group was lower than the control group,the differences were statis-tically significant(P<0.05).After treatment,FVC,FEV1 of the two groups were larger than those before treatment,FEV1/FVC were higher than that before treatment,and FVC,FEV1 in the research group were larger than those in the control group,FEV1/FVC was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the FBG levels of the two groups were lower than those before treat-ment,APTT,TT and PT were longer than those before treatment,and the FBG level of the research group was lower than that in the control group,APTT,TT and PT were longer than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of treat-ment in the research group was 96.67%,which was higher than 76.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion Terbutaline combined with cefoperazone sulbactam is effective in the treatment of COPD patients with pulmonary infection.It can effectively improve the inflammatory index,coagulation index,lung function and Th1/Th2 factor,which is worthy of clinical promotion and ap-plication.