阿奇霉素联合沙美特罗/氟替卡松对慢性阻塞性肺疾病患者的疗效及对血浆B型脑钠肽水平的影响
|
摘要
目的研究阿奇霉素联合沙美特罗/氟替卡松对慢性阻塞性肺疾病患者的疗效及对血浆B型脑钠肽(BNP)水平的影响。方法选择2015年1月—2017年12月新疆自治区人民医院米东医院收治的60例慢性阻塞性肺疾病患者,随机分为两组。对照组吸入沙美特罗/氟替卡松治疗,观察组在对照组基础上加用阿奇霉素,每次0.25 g,每天1次。两组均治疗6个月。比较两组临床疗效、每分钟最大通气量(MVV)、用力呼气量占用力肺活量比值(FEV1/FVC),并测量两组的6分钟步行距离,观察两组肿瘤坏死因子(TNF)-α、白介素(IL)-8、高敏C-反应蛋白(hs-CRP)和血浆BNP水平改变情况,记录两组的住院时间以及出院1年后的病死率。结果观察组总有效率为93.33%,明显高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗后,两组的MVV、6 min步行距离和FEV1/FVC均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组以上指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组的血清hs-CRP、TNF-α、IL-8和血浆BNP水平均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组以上指标明显低于对照组,差异有统计学意义(P<0.05)。观察组的住院时间及病死率均明显低于对照组(P<0.05)。结论阿奇霉素联合沙美特罗/氟替卡松对慢性阻塞性肺疾病患者的疗效确切,可明显减轻气道炎症反应,降低血浆BNP水平,改善肺功能,值得应用推广。
Objective To study the clinical effect of salmeterol/fluticasone combined with azithromycin on chronic obstructive pulmonary disease and its effect on plasma B-type brain natriuretic peptide level. Methods Selected 60 cases of patients with chronic obstructive pulmonary disease in our hospital from January 2013 to December 2017, divided into two groups randomly. The control group was treated with salmeterol/fluticasone inhalation, while the observation group was treated with azithromycin. Results The effective rate of the observation group was significantly higher than control group(P < 0.05). After treatment, MVV, 6-minute walking distance and FEV1/FVC in both groups were significantly increased(P < 0.05), especially in the observation group(P <0.05). The levels of serum hs-CRP, TNF-α, IL-8 and plasma BNP were significantly decreased in both groups, especially in the observation group(P < 0.05). The hospitalization time and mortality of the observation group were significantly lower than those of the control group(P < 0.05). Conclusion Salmeterol/fluticasone combined with azithromycin has definite curative effect on COPD patients. It can significantly reduce airway inflammation, reduce plasma BNP level and improve lung function. It is worth popularizing.
Objective To study the clinical effect of salmeterol/fluticasone combined with azithromycin on chronic obstructive pulmonary disease and its effect on plasma B-type brain natriuretic peptide level. Methods Selected 60 cases of patients with chronic obstructive pulmonary disease in our hospital from January 2013 to December 2017, divided into two groups randomly. The control group was treated with salmeterol/fluticasone inhalation, while the observation group was treated with azithromycin. Results The effective rate of the observation group was significantly higher than control group(P < 0.05). After treatment, MVV, 6-minute walking distance and FEV1/FVC in both groups were significantly increased(P < 0.05), especially in the observation group(P <0.05). The levels of serum hs-CRP, TNF-α, IL-8 and plasma BNP were significantly decreased in both groups, especially in the observation group(P < 0.05). The hospitalization time and mortality of the observation group were significantly lower than those of the control group(P < 0.05). Conclusion Salmeterol/fluticasone combined with azithromycin has definite curative effect on COPD patients. It can significantly reduce airway inflammation, reduce plasma BNP level and improve lung function. It is worth popularizing.
引文
[1]姚文飞,屠春林,赵开顺,等.慢性阻塞性肺疾病的肺康复研究进展[J].临床肺科杂志, 2017, 22(2):347-350.
[2]蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2017GOLD报告)解读[J].国际呼吸杂志, 2017, 37(1):6-17.
[3]张小娥,张彩莲.慢性阻塞性肺疾病流行病学及疾病经济负担研究进展[J].中国慢性病预防与控制, 2017, 25(6):472-476.
[4]刘旭东,吴俊丽,刘云,等.辛伐他汀联合阿奇霉素治疗老年慢性阻塞性肺疾病合并肺动脉高压患者的疗效[J].实用医学杂志, 2016, 32(7):1199-1200.
[5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志, 2013, 36(4):255-264.
[6]龚峰,张晓调,陈显静,等.慢性阻塞性肺疾病急性加重患者相关病毒感染的危险因素分析[J].中华医院感染学杂志, 2017, 27(4):800-803.
[7]刘星,冯旰珠.生物标志物在慢性阻塞性肺疾病急性加重期研究进展[J].临床肺科杂志, 2017, 22(5):934-937.
[8]庞才双,曾妮,申永春.慢性阻塞性肺疾病气道重塑机制及其研究进展[J].西部医学, 2017, 29(1):135-140.
[9]刘娅钦,马丽,刘琳.慢性阻塞性肺疾病发病机制的研究进展[J].临床肺科杂志, 2016, 21(6):1113-1117.
[10]张媚霞,孙志芬,曲桂红.小剂量阿奇霉素联合噻托溴铵治疗老年慢性阻塞性肺疾病的临床疗效观察[J].实用心脑肺血管病杂志, 2016, 24(7):111-113, 114.
[11]孙志芬,曲桂红,张媚霞,等.阿奇霉素联合百令胶囊治疗慢性阻塞性肺疾病疗效观察[J].中国药师, 2016, 19(7):1311-1313.
[12]欧立文,卢平.低剂量阿奇霉素对慢性阻塞性肺疾病稳定期患者气道中肿瘤坏死因子-α的影响及疗效[J].中国老年学, 2014, 34(3):656-657.
[13]李雪英,胡苏萍,陈国忠,等.炎症反应与慢性阻塞性肺疾病相关肺动脉高压及其血液高凝状态的关系[J].山东医药, 2017, 57(1):71-73.
[14]陈永春,王天轶.不同时期慢性阻塞性肺疾病患者血清炎性因子水平和肺功能情况分析[J].解放军医药杂志,2017, 29(4):38-40.
[15]毛陇军,李英,强华.阿托伐他汀对慢性阻塞性肺疾病合并肺动脉高压患者血清炎症因子水平、肺功能及右心室重塑的影响[J].药物评价研究, 2017, 39(9):1323-1326.
[16]张忠华,徐东波,邬波.慢性阻塞性肺疾病急性加重期并发肺动脉高压患者血浆BNP水平的变化[J].宁夏医科大学学报, 2017, 39(7):837-839.
[2]蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2017GOLD报告)解读[J].国际呼吸杂志, 2017, 37(1):6-17.
[3]张小娥,张彩莲.慢性阻塞性肺疾病流行病学及疾病经济负担研究进展[J].中国慢性病预防与控制, 2017, 25(6):472-476.
[4]刘旭东,吴俊丽,刘云,等.辛伐他汀联合阿奇霉素治疗老年慢性阻塞性肺疾病合并肺动脉高压患者的疗效[J].实用医学杂志, 2016, 32(7):1199-1200.
[5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志, 2013, 36(4):255-264.
[6]龚峰,张晓调,陈显静,等.慢性阻塞性肺疾病急性加重患者相关病毒感染的危险因素分析[J].中华医院感染学杂志, 2017, 27(4):800-803.
[7]刘星,冯旰珠.生物标志物在慢性阻塞性肺疾病急性加重期研究进展[J].临床肺科杂志, 2017, 22(5):934-937.
[8]庞才双,曾妮,申永春.慢性阻塞性肺疾病气道重塑机制及其研究进展[J].西部医学, 2017, 29(1):135-140.
[9]刘娅钦,马丽,刘琳.慢性阻塞性肺疾病发病机制的研究进展[J].临床肺科杂志, 2016, 21(6):1113-1117.
[10]张媚霞,孙志芬,曲桂红.小剂量阿奇霉素联合噻托溴铵治疗老年慢性阻塞性肺疾病的临床疗效观察[J].实用心脑肺血管病杂志, 2016, 24(7):111-113, 114.
[11]孙志芬,曲桂红,张媚霞,等.阿奇霉素联合百令胶囊治疗慢性阻塞性肺疾病疗效观察[J].中国药师, 2016, 19(7):1311-1313.
[12]欧立文,卢平.低剂量阿奇霉素对慢性阻塞性肺疾病稳定期患者气道中肿瘤坏死因子-α的影响及疗效[J].中国老年学, 2014, 34(3):656-657.
[13]李雪英,胡苏萍,陈国忠,等.炎症反应与慢性阻塞性肺疾病相关肺动脉高压及其血液高凝状态的关系[J].山东医药, 2017, 57(1):71-73.
[14]陈永春,王天轶.不同时期慢性阻塞性肺疾病患者血清炎性因子水平和肺功能情况分析[J].解放军医药杂志,2017, 29(4):38-40.
[15]毛陇军,李英,强华.阿托伐他汀对慢性阻塞性肺疾病合并肺动脉高压患者血清炎症因子水平、肺功能及右心室重塑的影响[J].药物评价研究, 2017, 39(9):1323-1326.
[16]张忠华,徐东波,邬波.慢性阻塞性肺疾病急性加重期并发肺动脉高压患者血浆BNP水平的变化[J].宁夏医科大学学报, 2017, 39(7):837-839.