摘要
目的观察大剂量氨溴索联合左氧氟沙星治疗老年慢性阻塞性肺疾病(COPD)合并重症肺炎的临床效果。方法选取2022年5月—2024年5月南京医科大学附属淮安第一医院收治的老年COPD合并重症肺炎患者114例,按照随机数字表法分为大剂量组和小剂量组,每组57例。小剂量组给予小剂量氨溴索联合左氧氟沙星治疗,大剂量组给予大剂量氨溴索联合左氧氟沙星治疗,2组均持续治疗2周。比较2组疗效,治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、6 min步行距离(6MWD)]、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及不良反应。结果大剂量组总有效率为98.25%,高于小剂量组的84.21%(χ^(2)=7.015,P=0.008)。治疗2周后,2组FEV_(1)、FVC升高,6MWD延长,CRP、TNF-α水平均降低,且大剂量组变化幅度大于小剂量组(P<0.01);大剂量组CD4^(+)、CD4^(+)/CD8^(+)升高,CD8^(+)降低,且高/低于同期小剂量组,小剂量组CD4^(+)、CD8^(+)低于治疗前,CD4^(+)/CD8^(+)高于治疗前(P<0.01)。大剂量组不良反应总发生率较小剂量组低(1.75%vs.12.28%,χ^(2)=4.839,P=0.029)。结论大剂量氨溴索联合左氧氟沙星治疗老年COPD合并重症肺炎效果较好,可明显改善肺功能,缓解炎性反应,提高免疫功能,减少不良反应。
Objective To observe the clinical efficacy of high-dose ambroxol combined with levofloxacin in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)complicated with severe pneumonia.Me thods A total of 114 elderly patients with COPD complicated with severe pneumonia admitted to the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University from May 2022 to May 2024 were selected and divided into high-dose group and low-dose group according to random number table method,with 57 cases in each group.The low-dose group was given low-dose ambroxol combined with levofloxacin,and the high-dose group was given high-dose ambroxol combined with levofloxacin,both groups were treated for 2 weeks.The efficacy,pulmonary function indexes(FEV_(1),FVC,6MWD),inflammatory factors(CRP,TNF-α),immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))before and after treatment,and adverse reactions were compared between two groups.Results The total effective rate of high-dose group was 98.25%,which was higher than 84.21%of low-dose group(χ^(2)=7.015,P=0.008).After 2 weeks of treatment,FEV_(1)and FVC were increased,6MWD was prolonged,CRP and TNF-αlevels were decreased in two groups,and the change range of high-dose group were greater than those of low-dose group(P<0.01).In high-dose group,CD4^(+)and CD4^(+)/CD8^(+)increased,and CD8^(+)decreased,and they were higher/lower than those in low-dose group at the same period,and CD4^(+)and CD8^(+)in low-dose group were lower than before treatment,and CD4^(+)/CD8^(+)was higher than before treatment(P<0.01).The ove rall incidence of adverse reactions in the high-dose group was lower than that in the low-dose group(1.75%vs.12.28%,χ^(2)=4.839,P=0.029).C onclusion High-dose ambroxol combined with levofloxacin is effective in the treatment of elderly COPD complicated with severe pneumonia,which can significantly improve lung function,alleviate inflammatory response,improve immune function and reduce adverse reactions.
作者
王亮
王保兰
姜洁
乔进
WANG Liang;WANG Baolan;JIANG Jie;QIAO Jin(Department of Respiratory and Critical Care Medicine,the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University,Jiangsu Province,Huai′an 223300,China;不详)
出处
《临床合理用药》
2025年第16期5-7,26,共4页
Chinese Journal of Clinical Rational Drug Use
基金
江苏省药学会—恒瑞医院药学基金科研项目(H202015)。
关键词
慢性阻塞性肺疾病
重症肺炎
氨溴索
大剂量
左氧氟沙星
肺功能
炎性因子
免疫功能
Chronic obstructive pulmonary disease
Severe pneumonia
Ambroxol,high-dose
Levofloxacin
Lung function
Inflammatory factors
Immune function
