盐酸左沙丁胺醇雾化联合糖皮质激素治疗急性加重期慢性阻塞性肺疾病临床效果研究

Effect of albuterol nebulization combined with glucocorticoid regimen on pulmonary ventilatory function and expression of proinflammatory factors in AECOPD patients

目的盐酸左沙丁胺醇雾化联合糖皮质激素治疗急性加重期慢性阻塞性肺疾病(AECOPD)的临床效果。方法选取自2020年8月至2023年7月界首市人民医院收治的50例AECOPD患者为研究对象,根据用药方式分成激素组和联合组,每组25例。激素组采用注射用甲泼尼龙琥珀酸钠治疗,联合组在基于激素组治疗方式的基础上,加入盐酸左沙丁胺醇雾化治疗。比较两组的治疗总有效率、用药前后疾病严重程度、促炎因子水平、血气指标、血常规、呼吸动力学和肺通气功能,另将两组药物不良反应发生率。结果治疗后,联合组的治疗总有效率高于激素组,不良反应发生率低于激素组,差异有统计学意义(P<0.05)。治疗后,两组急性生理与慢性健康Ⅱ评分、临床慢性肺部阻塞症调查问卷评分、C反应蛋白、降钙素原、白细胞介素-6、丙二醛、动脉二氧化碳分压、平均气道压、气道阻力水平下降,谷胱甘肽过氧化物酶、超氧化物歧化酶、动脉血氧分压、血氧饱和度、吸气峰值压、用力肺活量、第一秒用力呼气容积、呼吸峰值流速上升水平均升高,联合组变化更为显著,差异均有统计学意义(P<0.05)。结论盐酸左沙丁胺醇雾化结合糖皮质激素可有效治疗AECOPD,降低疾病严重程度,对机体炎症状态、血气指标与呼吸动力学指标均有改善作用,可提高肺通气功能,不良反应少,安全性高。

Objective Clinical effect of salbutamol aerosol combined with glucocorticoid in the treatment of acute exacerbation chronic obstructive pulmonary disease(AECOPD).Methods 50 patients with AECOPD were selected as the study objects and divided into hormone group and combination group according to medication methods,with 25 cases in each group.The hormone group was treated with methylprednisolone sodium succinate for injection,and the combined group was treated with salbutamol atomization based on the hormone group.The total effective rate,disease severity before and after treatment,proinflammatory factor level,blood gas index,blood routine,respiratory dynamics and pulmonary ventilation function of the two groups were compared,and the incidence of adverse drug reactions between the two groups were also compared.Results After treatment,the total effective rate of combined group was higher than that of hormone group,and the incidence of adverse reactions was lower than that of hormone group,the difference was statistically significant(P<0.05).After treatment,acute physiology and chronic health evaluationⅡ,clinical COPD qusetionnaire scores,C-reactive protein,procalcitonin,interleukin-6,malondialdehyde,arterial partial pressure of carbon dioxide,mean airway pressure and airway resistance levels decreased in both groups.Glutathione peroxidase,superoxide dismutase,arterial partial oxygen pressure,blood oxygen saturation peak inspiratory pressure,forced vital capacity,forced expiratory volume in the first second and peak respiratory flow rate were all increased,and the changes were more significant in combination group,with statistical significance(P<0.05).Conclusion Salbutamol aerosol combined with glucocorticoid can effectively treat AECOPD,reduce the severity of the disease,improve the inflammatory state of the body,blood gas indexes and respiratory dynamics indexes,improve lung ventilation function,less adverse reactions,and high safety.