多索茶碱联合特布他林对全肺灌洗尘肺患者炎症水平及肺功能的影响

Effects of doxofylline combined with terbutaline on inflammatory level and lung function in pneumoconiosis patients with whole lung lavage

目的探讨多索茶碱联合特布他林对行全肺灌洗术治疗的尘肺患者炎症水平及肺功能的影响。方法回顾性分析2021年6月至2023年2月于本院进行大容量全肺灌洗术治疗的45例尘肺患者病例资料,其中对照组23例,为术后仅给予多索茶碱治疗病例;观察组22例,为同时接受多索茶碱联合特布他林治疗病例,对比两组患者的临床资料、肺功能指标、炎症因子水平及血气分析指标变化。采用随机行走模型评价两组患者肺功能、炎症因子水平改善情况。结果两组患者治疗前肺功能用力肺活量(FVC)、第1秒用力呼气容积与肺活量比值(FEV1.0/FVC)及最大通气量(MVV)差异无统计学意义(P>0.05),但治疗后肺功能指标均明显高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05);与术前相比,两组患者术后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均明显降低,转化生长因子-β1(TGF-β1)水平明显增加,且观察组改善效果优于对照组(P<0.05);两组患者术后动脉血氧分压(PaO_(2))明显增加,肺泡动脉氧分压差(PA-aO_(2))、二氧化碳分压(PaCO_(2))明显降低,观察组血气分析各指标改善效果较对照组显著(P<0.05);TGF-β1与FVC、FEV1.0/FVC及MVV呈显著正相关性,与IL-6、TNF-α呈明显负相关(P<0.05);广义估计方程分析评价显示,观察组各指标改善情况明显优于对照组。结论TGF-β1与尘肺病患者肺功能指标呈正相关,多索茶碱联用特布他林对改善大容量全肺灌洗术后尘肺病患者肺功能、血气分析及炎症因子水平效果优于单用多索茶碱。

Objective To investigate the effects of doxofylline combined with terbutaline on inflammatory level and lung function in pneumoconiosis patients with whole lung lavage.Methods This was a retrospective analysis of the medical records of 45 patients with pneumoconiosis who underwent large-volume whole lung lavage surgery in our hospital from June 2021 to February 2023,among them,23 patients only received doxofylline treatment were divided into control group,and another 22 patients who received both doxofylline and terbutaline treatment were divided into observation group.Compare the clinical data,lung function indexes,inflammatory factor levels and blood gas analysis indexes of two groups of patients,then evaluate the improvement of lung function and inflammatory factor levels of the patients between two groups using a random walking model.Results The results showed that there was no significant difference in lung function such as FVC,FEV1.0/FVC and MVV between two groups before treatment(P>0.05),but after treatment,these lung function indexes were all significantly higher than those before treatment(P<0.05),and these indicators in observation group were significantly higher than that of control group(P<0.05);compared with preoperation,the serum levels of IL-6 and TNF-αin patients of both groups decreased significantly,the levels of TGF-β1 was significanly increased,and these improvements in observation group was more obvious than that in the control group(P<0.05);after operation,PaO_(2) significantly increased,PA-aO_(2) and PaCO_(2) significantly decreased in both two groups,the improvement of these indicators in observation group was also more significant than that of the control group(P<0.05);additionally,there was a significant positively correlation between TGF-β1 and FVC,FEV1.0/FVC,MVV,as well as a negatively correlation with IL-6 and TNF-α(P<0.05),furthermore,the generalized estimation equation analysis evaluation showed that the improvement of each these various indexes in observation group was obviously better than that in control group.Conclusion The results suggested that TGF-β1 showed positively correlation with lung function indexes in pneumoconiosis patients,and the combination application of doxofylline and terbutaline had a better effect on improving lung function,blood gas analysis indicators and serum levels of inflammatory factors in pneumoconiosis patients after large-volume whole lung lavage than doxofylline alone.