普米克令舒联合多索茶碱在慢性阻塞性肺疾病急性加重期中的应用价值及对患者炎症指标的影响

The application value of pulmicresol combined with doxofylline in patients with acute exacerbation of chronic obstructive pulmonary disease and its effect on inflammation indexes

目的探讨普米克令舒联合多索茶碱在慢性阻塞性肺疾病(COPD)患者急性加重期中的应用价值及对患者炎症指标的影响。方法选取2019年5月至2021年5月北京市昌平区史各庄社区卫生服务中心收治的100例COPD急性加重期患者作为研究对象,随机分为对照组与观察组,每组50例。对照组采用单纯多索茶碱治疗,观察组采用普米克令舒联合多索茶碱治疗,比较两组肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、峰值呼气流速(PEF)]、临床症状消失时间、炎症指标[白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]及临床疗效。结果治疗后,两组FEV1、FVC均大于治疗前,PEF均快于治疗前,且观察组FEV1、FVC均大于对照组,PEF快于对照组,差异有统计学意义(P<0.05);观察组咳嗽、喘息、哮鸣音、湿啰音症状消失时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组IL-17、TNF-α、PCT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);治疗后,两组PaO_(2)水平均高于治疗前,PaCO_(2)水平均低于治疗前,且观察组PaO_(2)水平高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为96.00%,高于对照组的82.00%,差异有统计学意义(P<0.05)。结论普米克令舒联合多索茶碱治疗COPD急性加重期疗效显著,可有效改善患者炎症反应和肺功能,促进临床症状改善,值得临床推广应用。

Objective To investigate the application value of pulmicresol combined with doxofylline in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)and its effect on inflammatory indexes.Methods A total of 100 patients with acute exacerbation of COPD admitted to Shigezhuang Community Health Service Center from May 2019 to May 2021 were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 50 cases in each group.The control group was treated with doxofylline alone,and the observation group was treated with pulmicresol combined with doxofylline.The pulmonary function indexes(forced expiratory volume in one second[FEV1],forced vital capacity[FVC],peak expiratory flow rate[PEF]),disappearance time of clinical symptoms,inflammatory indexes(interleukin-17[IL-17],tumor necrosis factor-α[TNF-α],procalcitonin[PCT]),blood gas indexes(arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)])and clinical efficacy were compared between the two groups.Results After treatment,FEV1 and FVC of the two groups were higher than those before treatment,and PEF was faster than that before treatment,and FEV1 and FVC in observation group were higher than those in the control group,and PEF was faster than that in the control group,the differences were statistically significant(P<0.05).The disappearance time of cough,wheezing,wheezing rale and moist rale in the observation group was shorter than those in the control group,and the dif-ferences were statistically significant(P<0.05).After treatment,the levels of IL-17,TNF-αand PCT of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of PaO_(2) of the two groups were higher than those before treatment,and the levels of PaCO_(2) were lower than before treatment,the levels of PaO_(2) in the observation group was higher than that in the control group,and the levels of PaCO_(2) was lower than that in the control group,the differ-ences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 96.00%,which was higher than 82.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Pulmicresol combined with doxofylline is effec-tive in the treatment of acute exacerbation of COPD,it can effectively improve the inflammatory response and lung function of patients,and promote the improvement of clinical symptoms,it is worthy of clinical promotion and application.