多索茶碱治疗COPD急性发作期的临床效果及对气道重塑和呼吸功能的影响

Clinical effect of doxofylline in the treatment of acute exacerbation of COPD and its effect on airway remodeling and respiratory function

目的观察多索茶碱治疗慢性阻塞性肺疾病(COPD)急性发作期的临床效果及对气道重塑和呼吸功能的影响。方法选取2020年3月—2022年7月兰州市第二人民医院收治的COPD急性发作期患者70例,根据随机数字表法分为观察组和对照组,每组35例。在常规对症治疗基础上,观察组予多索茶碱治疗,对照组予氨茶碱治疗。比较2组治疗效果,治疗前后气道重塑血清指标[基质金属蛋白酶抑制因子-1(TIMP-1)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)、神经生长因子(NGF)]、呼吸功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气流量峰值(PEF)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))]。结果观察组治疗总有效率为94.29%,高于对照组的71.43%(χ2=6.437,P=0.011)。治疗后,2组TIMP-1、MMP-3、MMP-9、NGF水平较治疗前降低,且观察组低于对照组(P均<0.01);2组FEV_(1)、FVC、PEF较治疗前升高,且观察组高于对照组(P<0.05或P<0.01);2组PaO_(2)、SaO_(2)水平高于对照组,PaCO_(2)水平低于对照组,且观察组变化幅度大于对照组(P均<0.01)。结论多索茶碱治疗COPD急性发作期患者疗效确切,可有效促进血气分析指标、气道重塑、呼吸功能改善。

Objective To observe the clinical effect of doxofylline in the treatment of acute exacerbation of COPD and its effect on airway remodeling and respiratory function.Methods Seventy patients with acute exacerbation of COPD admitted to the Second People′s Hospital of Lanzhou City from March 2020 to July 2022 were selected and randomly divided into observation group and control group,with 35 cases in each group.On the basis of conventional symptomatic treatment,the observation group was treated with doxofylline,and the control group was treated with aminophylline.The treatment effect,serum indexes of airway remodeling(TIMP-1,MMP-3,MMP-9,NGF),respiratory function indexes(FEV_(1),FVC,PEF),blood gas analysis indexes(PaO_(2),PaCO_(2),SaO_(2))were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 94.29%,which was higher than 71.43%of the control group(χ2=6.437,P=0.011).After treatment,the levels of TIMP-1,MMP-3,MMP-9 and NGF in the two groups were lower than those before treatment,and the observation group was lower than that in the control group(P<0.01).The FEV_(1),FVC and PEF in the two groups were higher than those before treatment,and the observation group was higher than that in the control group(P<0.05 or P<0.01).The levels of PaO_(2)and SaO_(2)in the two groups were higher than those in the control group,and the levels of PaCO_(2)were lower than those in the control group,and the change amplitude in the observation group was greater than that in the control group(P<0.01).Conclusion Doxofylline is effective in the treatment of patients with acute exacerbation of COPD,and can effectively promote blood gas analysis indicators,airway remodeling,and respiratory function improvement.