摘要
目的:探讨噻托溴铵联合甲泼尼龙治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及对患者血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)水平的影响。方法:将2017年1月至2019年4月在深圳市蛇口人民医院就诊的90例老年AECOPD患者作为研究对象。采用随机分组的原则将这90例AECOPD患者分为噻托溴铵组和噻-甲组,每组各45例患者。对两组患者均进行常规治疗。在此基础上,为噻托溴铵组患者采用噻托溴铵进行治疗,为噻-甲组患者采用噻托溴铵联合甲泼尼龙进行治疗。然后比较两组患者的治疗效果、血清PCT、hs-CRP的水平、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC%)和呼吸困难症状的评分。结果:与噻托溴铵组患者相比,噻-甲组患者治疗的总有效率更高,P<0.05。治疗后,噻-甲组患者血清PCT、hs-CRP的水平、呼吸困难症状的评分均低于噻托溴铵组患者,其FEV1、FEV1%、FEV1/FVC均高于噻托溴铵组患者,P<0.05。结论:噻托溴铵联合甲泼尼龙治疗老年AECOPD的疗效较好,可有效地降低患者血清PCT、hs-CRP的水平,缓解其呼吸困难的症状,改善其肺功能。
Objective:To investigate the efficacy of tiotropium combined with methylprednance in the treatment of acute exacerbation of senile chronic obstructive pulmonary disease(AECOPD)and its effect on serum levels of procalcitonin(PCT)and hypersensitive C-reactive protein(HS-CRP).Methods:A total of 90 elderly AECOPD patients admitted to Shenzhen Shekou People’s Hospital from January 2017 to April 2019 were selected as study subjects.The 90 AECOPD patients were randomized into tiotropium and Tiotropium,with 45 patients in each group.Both groups received routine treatment.On this basis,tiotropium bromide was used for treatment in the Tiotropium group,and tiotropium bromide combined with methylprednylone was used for treatment in the Tiotropium group.Treatment outcomes,serum PCT,hs-CRP,forced expiratory volume at 1 second(FEV1),percentage of forced expiratory volume at 1 second(FEV1%),percentage of forced expiratory volume at 1 second(FEV1/FVC%),and dyspnea symptom scores were then compared between the two groups.Results:Compared with tiotropium group,the total effective rate of tiotropium group was higher(P<0.05).After treatment,the level of serum PCT,Hs-CRP and the score of dyspnea symptom in tiotropium group were all lower th an those in tiotropium group,and the FEV1,FEV1%and FEV1/FVC of tiotropium group were all higher than those in Tiotropium group,P<0.05.Conclusion:Tiotropium bromide combined with methylprednylone in the treatment of senile AECOPD has a good effect,which can effectively reduce the serum PCT and HS-CRP levels,relieve the symptoms of dyspnea,and improve the lung function of the patie nts.
作者
刘灼帆
Liu Zhuofan(Department of Respiratory Medicine,Shenzhen Shekou People’s Hospital,Shenzhen,Guangdong 518000)
关键词
噻托溴铵
甲泼尼龙
老年
慢性阻塞性肺疾病急性加重期
Tiotropium bromide
Methylprednisolone
Old age
Acute exacerbations of chronic obstructive pulmonary disease
