多索茶碱联合雾化吸入治疗对慢性阻塞性肺疾病患者血清TNF-α水平及肺功能影响的研究

发布时间：2018-04-20 22:40

本文选题：慢性阻塞性肺疾病 + 多索茶碱　；参考：《青海大学》2017年硕士论文

【摘要】：目的:本研究旨在探讨应用雾化吸入治疗与在此基础上加用多索茶碱的慢性阻塞性肺疾病患者TNF-a表达水平的差异,明确TNF-a与动脉血气指标、肺功能的关系。为临床合理用药提供可靠的循证医学证据。方法:选取我院入选慢性阻塞性肺疾病C、D组诊断标准患者,单纯药物组30例,给予雾化吸入硫酸沙丁胺醇溶液、布地奈德混悬液,联合药物组30例,在单纯药物组基础上联合应用给予多索茶碱静滴,两组治疗期均10天。采用ELISA法测定TNF-α浓度,并与肺功能及血气分析指标进行相关性比较,统计分析检测数据。结果:1.两组患者血清TNF-a水平治疗后较治疗前均下降,有统计学意义(P0.05);治疗后联合药物组与单纯药物组相比较TNF-a水平降低更为显著,差异有统计学意义(P0.05)。2.两组患者治疗后的肺功能指标(FEV1%pred、FVC%pred、PEF%pred、MMEF%pred)、血气分析指标(PaO_2、SaO_2、PaCO_2)较治疗前均有改善(P0.05),治疗后联合药物组与单纯药物组相比较肺功能、血气分析改善更为显著,差异有统计学意义(P0.05)。4.两组患者治疗前后血清TNF-a与PaCO_2呈正相关(P0.05),与FEV1%pred、FVC%pred、PEF%pred、MMEF%pred、PaO_2、SaO_2呈负相关(P0.05)。结论:1.随着慢性阻塞性肺疾病患者炎症的控制,其血清TNF-a的表达水平降低。2.多索茶碱联合雾化吸入治疗可明显降低TNF-a水平,减轻肺损伤,纠正缺氧。3.患者血清TNF-a升高,说明其参与了慢性阻塞性肺疾病的气道炎症过反应过程,并与肺功能受损有关。
[Abstract]:Objective: to investigate the difference of TNF-a expression between patients with chronic obstructive pulmonary disease (COPD) treated with atomization inhalation and doxofylline plus doxofylline, and to determine the relationship between TNF-a and arterial blood gas index and pulmonary function. To provide reliable evidence of evidence-based medicine for rational use of drugs in clinical practice. Methods: a total of 30 patients with chronic obstructive pulmonary disease (COPD) in group D were treated with aerosol inhalation of salbutamol sulfate and budesonide suspension, and 30 patients in the combined drug group were enrolled in the study, and 30 patients in the combined drug group were treated with nebulized salbutamol sulfate solution and budesonide suspension. Doxofylline was given intravenously on the basis of drug only in both groups for 10 days. The concentration of TNF- 伪 was measured by ELISA, and compared with pulmonary function and blood gas analysis. The result is 1: 1. The level of serum TNF-a in both groups was lower than that before treatment (P 0.05), and the level of TNF-a in the combined drug group was significantly lower than that in the simple drug group (P 0.05), the difference was statistically significant (P 0.05). After treatment, the pulmonary function indexes of both groups were improved by FEV1 pred and FVCCpredand PEFpredand MMEFpredg, the blood gas analysis index was P0.05, compared with that before treatment. After treatment, the pulmonary function in the combined drug group was better than that in the single drug group, and the difference was statistically significant (P 0.05P 0.05. 4) the difference was statistically significant (P 0.05P 0.05), and there was no significant difference between the two groups in blood gas analysis and blood gas analysis (P 0.05g. 4) after the treatment, the pulmonary function of the combined drug group was better than that of the control group (P 0.05%, P 0.05%, P 0.05%). There was a positive correlation between serum TNF-a and PaCO_2 before and after treatment in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups. Conclusion 1. With the control of inflammation in patients with chronic obstructive pulmonary disease, the expression of serum TNF-a decreased. 2. 2. Doxophylline combined with atomization inhalation can significantly reduce the level of TNF-a, alleviate lung injury, and correct hypoxia. 3. The increase of serum TNF-a in patients suggests that it is involved in the process of airway inflammatory overreaction in patients with chronic obstructive pulmonary disease and is related to the impairment of pulmonary function.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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