茶碱类药物在慢性阻塞性肺疾病急性加重期中的作用研究

Research on role of theophylline drugs in acute exacerbation stage of chronicobstructive pulmonary disease

目的 探讨茶碱类药物在慢性阻塞性肺疾病急性加重期(AECOPD)中的作用。方法 回顾性分析2016年1月至2022年9月该院收治的401例AECOPD患者的临床资料,根据是否使用茶碱类药物分为药物组(n=308)和对照组(n=93)。对照组予以常规治疗,药物组在常规治疗基础上加用茶碱类药物。比较两组患者住院时间、C反应蛋白(CRP)、降钙素原(PCT)、血常规[WBC、中性粒细胞、血红蛋白、血细胞比容(HCT)、血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、嗜酸性粒细胞、嗜碱性粒细胞]变化情况,对有差异的参数进行亚组分析,观察不同种类茶碱的影响。结果 治疗前,药物组和对照组的基线资料,氨茶碱组与多索茶碱组嗜碱性粒细胞比较差异无统计学意义(P>0.05)。治疗后,药物组与对照组PCT、CRP、WBC、中性粒细胞、血红蛋白、HCT、PLR、NLR、嗜酸性粒细胞比较差异无统计学意义(P>0.05);药物组住院时间较对照组短,嗜碱性粒细胞较对照组少,差异有统计学意义(P<0.05)。治疗后,药物组亚组中氨茶碱组住院时间与多索茶碱组比较差异无统计学意义(P>0.05),但嗜碱性粒细胞较多索茶碱组少,差异有统计学意义(P<0.05)。结论 茶碱类药物可明显缩短AECOPD患者的住院时间,减少嗜碱性粒细胞,氨茶碱与多索茶碱在缩短住院时间方面无明显差异,但氨茶碱对嗜碱性粒细胞的作用明显强于多索茶碱。

Objective To investigate the role of theophylline drugs in acute exacerbation stage of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of 401 patients with AECOPD admitted and treated in this hospital from January 2016 to September 2022 were retrospectively analyzed.The patients were divided into the drug group(n=308)and control group(n=93)according to whether or not using theophylline drugs.The control group was given the conventional treatment,and the drug group was given theophylline drugs on the basis of conventional treatment.The hospitalization duration,C-reactive protein(CRP),procalcitonin(PCT),blood routine[WBC,neutrophil,hemoglobin,hematocrit(HCT),platelet-lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR),eosinophils,basophil]changes were compared between the two groups,and the parameters with differences conducted the subgroup analysis to observe the effect of different types of theophylline.Results Before treatment,there was no statistically significant difference in the baseline data between the drug group and the control group,and the number of basophils between the aminophylline group and doxophylline group(P>0.05).After treatment,there was no statistically significant difference in PCT,CRP,WBC,neutrophil,hemoglobin,HCT,PLR,NLR and eosinophil between the drug group and control group(P>0.05).The length of hospital stay in the drug group was shorter than that of the control group,and the basophils count was less than that of the control group,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in the hospitalization duration in the aminophylline group and doxophylline group in the drug group subgroups(P>0.05),but the basophils count was higher than that of the doxofylline group(P<0.05).Conclusion Theophylline drugs could significantly shorten the hospitalization duration and reduce the basophils in the patients with AECOPD.There is no significant difference in shortening the hospitalization duration between aminophylline and doxophylline,but aminophylline’s effect on basophils is significantly stronger than that of doxophylline.