多索茶碱对COPD急性加重期疗效的影响

Effect of Doxothelline on Efficacy During Acute Exacerbation of COPD

目的探究多索茶碱联合复方异丙托溴铵对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重患者运动耐量及血清炎性介质水平的影响。方法采用随机数字表法将郑州大学附属洛阳中心医院2021年7月至2023年3月收治的COPD急性加重期患者78例分为观察组和对照组,每组39例。对照组给予复方异丙托溴铵治疗,观察组给予多索茶碱联合复方异丙托溴铵治疗,比较两组患者临床疗效,并检测肺功能、血清炎性因子水平、运动耐量,记录不良反应。结果观察组总有效率明显高于对照组(P<0.05);治疗后,与对照组相比,观察组患者1 s用力呼吸气容积(FEV1)、用力肺活量(FCV)、最大呼气流量(PEF)以及FEV1/FCV比值明显更高,超敏C反应蛋白(hs-CRP)、血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)明显更低,运动耐量评分明显更高,氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))明显高于更高,二氧化氮分压(PaCO_(2))明显更低,上述指标比较差异有统计学意义(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论对急性加重期COPD患者,较单药复方异丙托溴铵治疗,多索茶碱联合复方异丙托溴铵治疗能获得更好的临床效果,有效促进肺功能恢复,降低炎症反应,改善动脉血气,提高远动耐量,且不增加临床用药安全性风险。

Objective To investigate the effect of doxofylline combined with compound ipratropium bromide on exercise tolerance and serum inflammatory mediator levels in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 78 patients with acute exacerbation of COPD were admitted to the hospital from July 2021 to March 2023.They were divided into observation group(39 cases)and control group(39 cases)using the random number table.The control group was treated with compound ipratropium bromide,while the observation group was treated with doxofylline combined with compound ipratropium bromide.Comparison between groups was made on clinical efficacy,pulmonary function,serum inflammatory factor levels,exercise tolerance,and the incidence of adverse reactions.Results Comparison between groups found that the total clinical response rate in the observation group was higher(P<0.05);after treatment,compared with the control group,forced expiratory volume in 1s(FEV1),forced vital capacity(FCV),peak expiratory flow(PEF)and FEV1/FCV in observation group were significantly higher.The levels of high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)were significantly lower.The exercise tolerance score of observation group was significantly higher.After treatment,partial pressure of oxygen(PaO_(2))and arterial oxygen saturation(SaO_(2))in observation group were significantly higher,while partial pressure of nitrogen dioxide(PaCO_(2))was significantly lower.There was statistical significance in the above indexes(P<0.05),but there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion For patients with acute exacerbation of COPD,the combined treatment of doxofylline and compound ipratropium bromide can achieve better clinical effect than compound ipratropium bromide alone.It can effectively promote pulmonary function recovery,reduce inflammatory reactions,improve arterial blood gas and enhance exercise tolerance without increasing safety risk of clinical medication.