摘要
目的探讨乙酰半胱氨酸联合布地奈德治疗大面积脑梗死后继发肺部感染患者的临床疗效。方法2018年3月至2020年9月在我院进行治疗的106例大面积脑梗死后继发肺部感染患者,根据治疗方法不同分为对照组55例(布地奈德治疗)和联合组51例(布地奈德+乙酰半胱氨酸治疗)。比较两组治疗前、治疗后3个月临床症状消失时间,治疗前后氧化应激指标、免疫功能指标、血气指标改善情况,并分析用药安全性。结果联合组气喘、发热、咳嗽、肺部啰音等症状消失时间及肺部X射线阴影消失时间均短于对照组(P<0.05);治疗后两组SOD水平、CD4^(+)与CD4^(+)/CD8^(+)、PaO_(2)均高于治疗前,MDA水平、CD8^(+)及PaCO_(2)均低于治疗前,且联合组指标优于对照组(P<0.05);两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论乙酰半胱氨酸联合布地奈德治疗大面积脑梗死后继发肺部感染患者安全性高,可有效缓解患者诸多不适临床症状,改善氧化应激指标水平及机体缺氧程度,提高患者免疫力,具有良好的应用前景。
Objective To explore the clinical efficacy of acetylcysteine combined with budesonide in the treatment of patients with secondary pulmonary infection after massive cerebral infarction.Methods One hundred and six patients with secondary pulmonary infection after massive cerebral infarction treated in our hospital from March 2018 to September 2020 were selected.According to different treatments,they were divided into control group treated with budesonide(n=55)and combined group treated with budesonide+acetylcysteine(n=51).The disappearance time of clinical symptoms of patients in the two groups before and after 3 months of treatment was compared.The improvement in oxidative stress indexes,immune function indexes,and blood gas indexes before and after treatment was also compared.The safety of medication was analyzed.Results The disappearance time of pant,fever,cough,pulmonary rales and other symptoms and the disappearance time of lung shadow in X-ray in the combined group were all significantly shorter than those in the control group(P<0.05).After treatment,the levels of SOD,CD4^(+),CD4^(+)/CD8^(+)and PaO_(2) in the two groups were increased,and the levels of MDA,CD8^(+)and PaCO_(2) were decreased.The SOD,CD4^(+),CD4^(+)/CD8^(+)and PaO_(2) levels of the combined group were higher than those of the control group,and the MDA,CD8^(+)and PaCO_(2) levels were lower than those of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Acetylcysteine combined with budesonide has high safety in the treatment of patients with secondary pulmonary infection after massive cerebral infarction.It can effectively alleviate many uncomfortable clinical symptoms,improve the level of oxidative stress indicators and the degree of hypoxia,and improve the immunity of the patients.It has good application prospects.
作者
陈洁
冯伟
张琳琳
吕喆
王耀辉
张重阳
陈青松
CHEN Jie;FENG Wei;ZHANG Lin-lin;LV Zhe;WANG Yao-hui;ZHANG Chong-yang;CHEN Qing-song(Emergency Department,Qinhuangdao First Hospital,Qinhuangdao 066000,China)
出处
《实用医院临床杂志》
2021年第5期17-20,共4页
Practical Journal of Clinical Medicine
基金
秦皇岛市科学技术研究与发展计划(编号202004021)。
