摘要
目的探究老年慢性阻塞性肺疾病(COPD)患者采用哌拉西林-他唑巴坦联合甲泼尼龙治疗对临床症状及肺功能恢复的影响。方法回顾性分析北大医疗淄博医院呼吸内科2019年6月—2022年8月收治的92例老年COPD急性加重患者的临床资料,按治疗方法不同分为两组,每组46例。对照组采用哌拉西林-他唑巴坦治疗,观察组在此基础上采用甲泼尼龙治疗,均持续治疗1周。对比两组患者的临床症状消失时间、肺功能、炎性因子水平及安全性。结果观察组的咳嗽、咳痰、肺部啰音、呼吸困难及气促消失时间均短于对照组,组间差异有统计学意义(P<0.05)。治疗后,观察组的第1秒用力呼气容积、用力肺活量均大于对照组,呼气峰值流速快于对照组,组间差异有统计学意义(P<0.05)。治疗后,观察组的C反应蛋白、降钙素原水平分别为(21.37±3.13)mg/L、(0.17±0.03)ng/L,均低于对照组的(42.54±5.25)mg/L、(0.34±0.06)ng/L,组间差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论哌拉西林-他唑巴坦联合甲泼尼龙能有效改善老年COPD急性加重患者的肺功能,减轻其炎症反应,促进临床症状消退,且安全可靠。
Objective To investigate the effects of piperacillin-tazobactam combined with methylprednisolone on clinical symptoms and pulmonary function recovery in elderly patients with chronic obstructive pulmonary disease(COPD).Methods The clinical data of 92 elderly patients with acute exacerbation of COPD admitted to the Respiratory Department of Peking University Medical Zibo Hospital from June 2019 to August 2022 were retrospectively analyzed.They were divided into two groups according to different treatment methods,with 46 cases in each group.The control group was treated with piperacillintazobactam,and the observation group was treated with methylprednisolone on this basis.Both groups were treated for 1 week.The clinical symptom resolution time,pulmonary function,inflammatory factor levels and safety of the two groups were compared.Results The disappearance time of cough,expectoration,pulmonary rales,dyspnea and shortness of breath in the observation group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the first second forced expiratory volume and forced vital capacity of the observation group were greater than those of the control group,and the peak expiratory velocity was faster than that of the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the levels of C-reactive protein and procalcitonin in the observation group were(21.37±3.13)mg/L and(0.17±0.03)ng/L,respectively,which were lower than(42.54±5.25)mg/L and(0.34±0.06)ng/L in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Piperacillin-Tazobactam combined with methylprednisolone can effectively improve the pulmonary function,reduce the inflammatory response and promote the regression of clinical symptoms in elderly patients with acute exacerbation of COPD,and it is safe and reliable.
作者
张丛丛
ZHANG Congcong(Department of Respiratory Medicine,Peking University Medical Zibo Hospital,Zibo Shandong,255000,China)
出处
《反射疗法与康复医学》
2023年第11期110-112,128,共4页
Reflexology And Rehabilitation Medicine
关键词
老年
慢性阻塞性肺疾病
哌拉西林-他唑巴坦
甲泼尼龙
临床症状
肺功能
炎性因子
Elderly
Chronic obstructive pulmonary disease
Piperacillin-Tazobactam
Methylprednisolone
Clinical symptoms
Pulmonary function
Inflammatory factors
