地塞米松联合头孢呋辛钠治疗AECOPD合并肺气肿的疗效分析

发布时间：2018-04-14 03:33

本文选题：地塞米松 + 头孢呋辛钠　；参考：《中国药房》2016年36期

【摘要】：目的:探讨地塞米松联合头孢呋辛钠治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并肺气肿的疗效和安全性。方法:回顾性收集80例AECOPD合并肺气肿患者资料,按照用药不同分为观察组和对照组,每组40例。两组患者入院后均立即卧床休息,并给予营养支持、维持电解质平衡等对症支持治疗,与此同时,对照组患者给予注射用头孢呋辛钠1.5 g加入0.9%氯化钠注射液100 ml中静脉滴注,bid(若抗感染效果不佳则增加剂量至2.0 g);观察组患者在对照组治疗基础上加用地塞米松磷酸钠注射液5 mg加入0.9%氯化钠注射液20 ml中雾化吸入,bid。两组患者均连续治疗1周。观察两组患者治疗前后肺功能相关指标,包括6min步行距离(6MWT)、肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、呼气中断流速(MMEF)以及最高呼气流速(PEF)水平;炎症细胞因子水平,包括多形核白细胞(PMN)、白细胞介素(IL)-8、IL-17、超敏C反应蛋白(hs-CRP)和肿瘤坏死因子(TNF)-α水平;气管阻力相关指标,包括呼吸总阻抗(Z5)、共振频率(Fres)和总气管阻力(R5)水平;肝、肾功能指标,包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、尿素氮(BUN)、血肌酐(Scr)和尿肌酐(Ucr)水平。结果:治疗前两组患者肺功能相关指标、炎症细胞因子水平和气管阻力相关指标比较差异均无统计学意义(P0.05)。治疗后,两组患者肺功能相关指标显著高于同组治疗前,且观察组高于对照组,炎症细胞因子水平和气管阻力相关指标均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P0.05)。安全性方面,两组患者治疗前后肝、肾功能指标均在正常范围内。结论:地塞米松联合头孢呋辛钠治疗AECOPD合并肺气肿疗效较好,可明显改善患者的肺功能,降低患者的炎症反应和气管阻力,且安全性较好。
[Abstract]:Objective: to investigate the efficacy and safety of dexamethasone combined with cefuroxime sodium in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) with emphysema.Methods: 80 cases of AECOPD complicated with emphysema were collected retrospectively and divided into observation group and control group.The two groups were all in bed immediately after admission, and were given nutritional support, electrolyte balance and other symptomatic support treatment, at the same time,Patients in the control group were given 1.5 g cefuroxime sodium for injection plus 0.9% sodium chloride 100ml intravenous infusion of bidbidae (if the anti-infective effect was not good, the dose was increased to 2.0 g / g), while the patients in the observation group were treated with dexamethasone on the basis of the treatment in the control group.Sodium phosphate injection (5 mg) was added to 0.9% sodium chloride injection (20ml).The patients in both groups were treated continuously for 1 week.Pulmonary function related indexes were observed before and after treatment, including 6min walking distance (6MWTT), vital capacity (VV), FEV1 / FVC (FEV1 / FEV1 / FEV1), peak expiratory flow (MPEF) and peak expiratory flow (PEF), and inflammatory cytokines.These include polymorphonuclear leukocyte (PMN), interleukin-8 (IL-17), hypersensitive C-reactive protein hs-CRP (hs-CRP) and tumor necrosis factor- 伪 (TNF- 伪) levels; tracheal resistance-related parameters, including total respiratory impedance, resonance frequency (Fres5) and total trachea resistance (R5); liver and renal function.These include alanine aminotransferase (alt), aspartate transaminase (AST), urea nitrogen bun (bun), serum creatinine (SCR) and urinary creatinine (Ucrs).Results: there were no significant differences in pulmonary function, inflammatory cytokines and tracheal resistance between the two groups before treatment.After treatment, the pulmonary function related indexes in both groups were significantly higher than those before treatment in the same group, and the levels of inflammatory cytokines and tracheal resistance in the observation group were significantly lower than those in the control group, and the levels of inflammatory cytokines and tracheal resistance in the observation group were significantly lower than those in the control group.The difference was statistically significant (P 0.05).In terms of safety, the liver and kidney function indexes of both groups were within normal range before and after treatment.Conclusion: dexamethasone combined with cefuroxime sodium is effective in the treatment of AECOPD with emphysema.
【作者单位】：南通市第二人民医院药剂科;南通市第二人民医院呼吸科;
【分类号】：R563

【相似文献】