摘要
目的:探讨氨茶碱常规剂量对慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及药物安全性。方法:采用回顾性分析,选取2019年5—10月武汉大学附属同仁医院收治的100例AECOPD患者,按照血药浓度高低程度分为A(<5 mg/L)、B(≥5 mg/L且<15.00 mg/L)、C(≥15 mg/L)三组,比较三组患者使用常规剂量氨茶碱的临床疗效、治疗前后6 min步行试验(6MWT)、血气分析及肺功能变化、性别、年龄与氨茶碱血药浓度的相关性以及药物不良反应发生率。结果:使用氨茶碱治疗后,B组、C组的临床疗效均高于A组;3组患者6MWT(F=0.23)比较无统计学差异(P>0.05)。PaO2(F=172.5,P<0.001)、PaCO2(F=161.06,P<0.001)、SaO2(F=27.99,P<0.001)、FEV1(F=79.94,P<0.001)、FVC(F=19.05,P<0.001)及FEV1/FVC(F=123.30,P<0.001)各项指标水平改善明显,差异具有统计学意义(P<0.05)。女性氨茶碱浓度高于男性,氨茶碱血药浓度差异有统计学意义(t=-2.303,P=0.023),性别与氨茶碱血药浓度呈正相关(r=0.227,P=0.023),年龄与氨茶碱血药浓度无相关关系(P=0.88)。60岁以上患者不良反应发生例数较其余各年龄段偏高,而各年龄段之间不良反应差异无统计学意义(P>0.05)。结论:AECOPD患者使用氨茶碱治疗,应充分考虑患者年龄、性别、病理生理等因素,女性患者及老年患者应适当减少用量,以防不良反应发生。同时监测氨茶碱血药浓度并调控在5~15 mg/L。
Objective:To study the drug curative effect and safety of aminophylline at regular doses on acute exacerbation chronic obstructive pulmonary disease(AECOPD) patients.Methods:A total of100 cases of AECOPD were divided into three groups according to the blood drug concentration degree(group A:<5 mg/L;group B:5-15 mg/L;group C:≥15 mg/L).The clinical curative effect of aminophylline,6 MWT results before and after treatment,blood gas analysis,and lung function changes were compared among the three groups.Results:After treatment with aminophylline,the clinical efficacy in groups B and C was better than in group A;the concentrations of aminophylline in females were higher than those in males.Aminophylline blood drug concentration had no correlation to patients’ age.Conclusion:For the AECOPD patients with aminophylline treatment,related factors such as age,gender,and pathological physiology should be considered,and the dosages for female patients are lower than men’s.Regular blood drug concentration should be monitored on the range of 5-15 mg/L.
作者
戴芹
方思
赵玉
张恩景
DAI Qin;FANG Si;ZHAO Yu;ZHANG Enjing(Tongren Hospital of Wuhan University(Wuhan Third Hospital),Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2021年第1期151-155,共5页
Medical Journal of Wuhan University
基金
武汉市卫生健康委员会资助项目(编号:WZ19C10)。
关键词
慢性阻塞性肺疾病
氨茶碱
血药浓度
回顾性分析
Chronic Obstructive Pulmonary Disease
Aminophylline
Blood Drug Concentration
Retrospective Analysis
