慢性阻塞性肺病急性恶化合并呼吸衰竭患者肺部微生物变化研究

目的:探究慢性阻塞性肺病急性恶化合并呼吸衰竭患者肺部微生物变化。方法:收集我院收治的慢性阻塞性肺疾病急性恶化合并呼吸衰竭患者182例,取患者痰液标本接种于血平板、麦康凯平板、巧克力平板和沙保罗平板,检测患者的耐药性以及肺部微生物连续性变化。结果:(1)以革兰阴性菌为主,革兰阳性菌以及真菌成分较多,其微生物构成比例呈逐渐上升趋势(P<0.05);(2)铜绿假单胞菌中,四环素类药物耐药率呈下降趋势(P<0.05);丁胺卡那霉素、碳青霉烯类、盐酸左氧氟沙星、哌拉西林他唑巴坦以及头孢哌酮舒巴坦等耐药率呈上升趋势(P<0.05);(3)治鲍曼氏不动杆菌对常用抗生素、碳青霉烯类、头孢他啶以及氨曲南的耐药率呈上升趋势(P<0.05);对头孢哌酮舒巴坦药物呈下降趋势(P<0.05);(4)肺炎克雷伯菌对庆大霉素、碳青霉素类、β-内酰胺酶抑制剂联合制剂以及三代头孢类等药物的耐药率呈上升趋势(P<0.05);对哌拉西林他唑巴坦药物呈下降趋势(P<0.05)。(5)大肠埃希菌对大部分常用药物耐药率呈上升趋势(P<0.05);对头孢吡肟以及氨曲南的耐药率呈下降趋势,(P<0.05);(6)金黄色葡萄球菌对常用抗生素以及大部分药物耐药率呈上升趋势,(P<0.05);对克林霉素以及复方新诺明的耐药率呈下降趋势,(P<0.05)。结论:慢性阻塞性肺病急性恶化合并呼吸衰竭患者肺部微生物连续性变化对慢阻肺急性恶化合并呼吸衰竭病情发展以及治疗具有诊断意义。

Effects of Suhuang Zhike Capsules on Pulmonary Function and Peripheral Blood Eosinophil Count and Exhaled Nitric Oxide in Patients with Acute Attack of Bronchial Asthma

OBJECTIVE: To observe the effects of Suhuang Zhike Capsules on lung function and peripheral blood eosinophil count (EOS) and exhaled nitric oxide (eNO) in patients with acute asthma attack.METHODS: A total of 80 patients with acute exacerbation of bronchial asthma admitted to Huai'an Cancer Hospital from January 2017 to January 2018 were randomly divided into an observation group and a control group,with 40 cases in each group.The control group was given conventional treatment with western medicine,and the observation group was given Suhuang Zhike Capsules on the basis of the treatment method of the control group.After 1 week of treatment,the improvement of individual symptoms (cough,wheezing,wheezing rale),lung function [1 second forced expiratory volume (FEV1),forced expiratory volume occupational capacity of vital capacity (FVC) in 1 second and peak expiratory flow (PEF)] and peripheral blood EOS and eNO levels and efficacy before and after the treatment were observed and assessed.RESULTS: The total effective rate of the observation group was 92.5%,which was significantly higher than the total effective rate of the control group (75.0%)(P < 0.05).The cough,wheezing and wheezing scores of the 2 groups were significantly decreased after treatment (P < 0.05).The scores of the above symptoms were significantly lower in the observation group than in the control group (P < 0.05).The FEV1,FVC and PEF were significantly increased after treatment (P < 0.05),and the above lung functions in the observation group were significantly higher than the control group (all P < 0.05).The EOS and eNO levels in the peripheral blood of the 2 groups were significantly decreased after treatment (P < 0.05),and the EOS and eNO levels in the peripheral blood in the observation group were significantly lower than those in the control group (P < 0.05).CONCLUSION: Suhuang Zhike Capsules can reduce the levels of EOS and eNO in peripheral blood of patients with acute asthma attack,improve the lung function of patients,relieve the clinical symptoms and improve the prognosis.