摘要
目的:观察乌司他丁联合异丙托溴铵治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及对血清炎症因子、血管内皮功能、肺功能的影响。方法:将125例AECOPD病例依据随机分为观察组(64例)和对照组(61例)。对照组在常规治疗的基础上给予异丙托溴铵,观察组在对照组的基础上给予乌司他丁。治疗1周,观察两组疗效及血清炎症因子(hs-CRP、TNF-α、IL-1、IL-8)、血管内皮功能相关指标(ET-1、NO、TXB2、VEGF)、肺功能(TLC、PEF、PEF25、PEF50)的差异。结果:(1)疗效比较:观察组显效31例,有效29例,无效4例;对照组显效18例,有效37例,无效6例。两组疗效比较差异有统计学意义(Z=-2.123 P=0.034);(2)血清炎症因子水平比较:两组hs-CRP、TNF-α、IL-1、IL-8均明显下降(t观察组=23.173、19.294、8.382、16.291,P=0.000、0.000、0.000、0.000;t对照组=19.385、16.732、6.713、13.185,P=0.000、0.000、0.000、0.000),且观察组降幅大于对照组,同期比较差异有统计学意义(t=5.419、5.184、4.893、7.241,P=0.000、0.002、0.006、0.000);(3)血管内皮功能相关指标水平比较:两组NO、VEGF上升而ET-1、TXB2下降(t观察组=14.728、17.482、12.103、17.827,P=0.000、0.000、0.000、0.000;t对照组=11.745、12.483、6.386、12.097,P=0.000、0.000、0.000、0.000),且观察组变化幅度大于对照组,同期比较差异有统计学意义(t=9.182、18.831、6.271、11.382,P=0.000、0.000、0.000、0.000);(4)肺功能比较:两组TLC、FEV1、PEF25及PEF50均上升(t观察组=10.742、8.736、9.014、11.422,P=0.000、0.000、0.000、0.000;t对照组=7.618、6.801、7.194、8.275,P=0.000、0.000、0.000、0.000),且观察组变化幅度大于对照组,同期比较差异有统计学意义(t=5.402、4.927、4.238、5.701,P=0.009、0.011、0.019、0.003)。结论:乌司他丁联合异丙托溴铵治疗AECOPD的疗效确切,能更有效的抑制炎症反应、保护血管内皮功能及肺功能。
Objective:To observe the efficacy and effect on serum inflammatory factors,vascular endothelial function and pulmonary function of ulinastatin combined with ipratropium bromide in the treatment of AECOPD.Methods:125 cases of patients with AECOPD were randomly divided into observation group(64 cases)and control group(61 cases).The control group were given ipratropium bromide based on conventional therapy,and the observation group were given ulinastatin based on the control group.After 1 week,to observe the clinical efficacy and differences of serum inflammatory factors(hs-CRP,TNF-α,IL-1,IL-8),vascular endothelial function related indicators(ET-1,NO,TXB2,VEGF),and pulmonary function(TLC,PEF1,PEF25,PEF50)between the two group.Results:①Comparison of curative efficacy the observation group,excellence got 32 cases,effective got 32 cases,invalid 4 cases failure,and those of the control group was 18 cases,37 cases and 6 cases.The clinical efficacy of the two groups showed significant difference(Z=-2.123 P=0.034);②Comparison of serum inflammatory factors,and all indexs of the observation group improved more significantly than that of the control group,with statistical difference(t=5.419,5.184,4.893,7.241 P=0.000,0.002,0.006,0.000);③Comparison of vascular endothelial function.The two groups of NO,VEGF were decreased and ET-1,TXB2 were decreased,and all indexs of the observation group improved more significantly than that of the control group,with statistical difference(t=9.182,18.831,6.271,11.382 P=0.000,0.000,0.000,0.000);④Comparison of vascular pulmonary function.The two groups of TLC,PEF1,PEF25,PEF50 were increased with before,and all the indexs of the observation group improved more significantly than that of the control group,with statistical difference(t=5.402,4.927,4.238,5.701 P=0.009,0.011,0.019,0.003).Conclusion:Ulinastatin combined with ipratropium bromide is effective in the treatment of AECOPD,which can effectively inhibit the inflammatory reaction,protect the vascular endothelial function and lung fun
作者
龙升华
张菁
柯正华
许伟
黄丹
LONG Shenghua(The Central Hospital of Huangshi of Edong Medical Group,Hubei Huangshi 435000,China)
出处
《河北医学》
CAS
2018年第4期556-560,共5页
Hebei Medicine
基金
湖北省自然科学基金计划项目
(编号:ZRY0857)
关键词
慢性阻塞性肺疾病
异丙托溴铵
乌司他丁
Chronic obstructive pulmonary disease
Ipratropium bromide
Ulinastatin
