复方异丙托溴氨联合甲泼尼龙对慢性阻塞性肺疾病急性加重期患者炎症因子和血气水平的影响

Effect of compound ipratropium bromide combined with methylprednisolone on inflammatory factors and blood gas levels in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探究复方异丙托溴氨联合甲泼尼龙对慢性阻塞性肺疾病(COPD)急性加重期患者炎症因子和血气水平的影响。方法选取2019年3月至2021年3月于辽阳市第二人民医院治疗的106例COPD急性加重期患者作为研究对象,按照随机数字表法分为观察组与对照组,每组53例。对照组采用常规治疗,观察组在对照组基础上给予复方异丙托溴胺联合甲泼尼龙治疗,比较两组白细胞介素-4(IL-4)和白细胞介素-8(IL-8)及干扰素-γ(IFN-γ)水平、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及最大自主通气量(MVV)。结果治疗后,两组IFN-γ水平均高于治疗前,IL-4、IL-8水平均低于治疗前,且观察组IFN-γ水平高于对照组,IL-4、IL-8水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组PaO_(2)高于治疗前,PaCO_(2)低于治疗前,且观察组PaO_(2)高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。治疗后,两组FEV1、FVC及MVV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)。结论复方异丙托溴胺联合甲泼尼龙用于治疗COPD急性加重期疗效显著,能有效改善患者炎症及血气分析指标,提高患者的肺功能,值得临床推广应用。

Objective To explore the effect of compound ipratropium bromide combined with methylprednisolone on inflammatory factors and blood gas levels in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods 106 patients with acute exacerba-tion of COPD who were treated in Liaoyang Second People's Hospital from March 2019 to March 2021 were selected as the research subjects,they were divided into the observation group and the control group according to the table random number method,with 53 cases in each group.The con-trol group was treated with conventional therapy,and the observation group was treated with compound ipratropium bromide combined with methyl-prednisolone on the basis of the control group.The levels of interleukin-4(IL-4),interleukin-8(IL-8)and interferon-γ(IFN-γ),arterial partial pres-sure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and maximum voluntary ventilation(MVV)were compared between the two groups.Results After treatment,the levels of IFN-γof the two groups were higher than those before treatment,and the levels of IL-4 and IL-8 were lower than those before treatment,and the levels of IFN-γin the observation group were higher than those in the control group,and the levels of IL-4 and IL-8 were lower than those in the control group,the differ-ences were statistically significant(P<0.05).After treatment,PaO_(2) of the two groups was higher than that before treatment,PaCO_(2) was lower than that before treatment,and PaO_(2) in the observation group was higher than that in the control group,PaCO_(2) was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,FEV1,FVC and MVV of the two groups were higher than those before treat-ment,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).Conclusion Compound ipratropium bromide combined with methylprednisolone is effective in the treatment of acute exacerbation of COPD,it can effectively improve the inflammation and blood gas levels of patients and improve the lung function of patients,and is worthy of clinical promotion and application.