摘要
目的 探讨头孢哌酮舒巴坦联合布地奈德吸入对细菌感染导致慢性阻塞性肺疾病急性加重期(AECOPD)的老年患者细菌清除效果、通气功能及炎症因子的影响.方法 前瞻性选取2022年1月至2023年12月在长沙市第三医院就诊的70例细菌感染导致AECOPD的老年患者进行研究,按照随机数字表法将其分为对照组(n=35)与观察组(n=35).对照组给予常规疗法联合布地奈德吸入,观察组在对照组基础上给予头孢哌酮舒巴坦.比较两组患者的治疗有效率,细菌清除率,治疗前和治疗14 d后的通气功能[呼气峰值流速(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)]、炎症因子指标[降钙素原(PCT)、白细胞介素-6(IL-6)]以及不良反应发生情况.结果 观察组治疗有效率为94.29％,高于对照组(77.14％),差异有统计学意义(P＜0.05).观察组细菌清除率为93.75％,高于对照组(78.26％),差异有统计学意义(P＜0.05).治疗14 d后,两组患者的PEF、FVC、FEV1均较治疗前升高,且观察组患者的 PEF、FVC、FEV1 分别为(3.72±0.75)L/s、(2.31±0.32)L、(1.42±0.41)L,均高于对照组[(3.19±0.59)L/s、(2.05±0.28)L、(1.10±0.37)L],差异均有统计学意义(P＜0.05).治疗14 d后,两组患者的PCT、IL-6水平均较治疗前降低,且观察组患者的PCT、IL-6水平分别为(1.12±0.38)ng/mL、(23.16±5.53)ng/L,均低于对照组[(1.47±0.45)ng/mL、(29.48±5.74)ng/L],差异均有统计学意义(P＜0.05).观察组与对照组患者总不良反应发生率比较(8.57％vs.5.71％),差异无统计学意义(P＞0.05).结论 头孢哌酮舒巴坦联合布地奈德吸入对细菌感染导致AECOPD的老年患者应用良好,可改善患者通气功能,抑制炎症因子水平,显著提高疗效且安全性良好.
Abstract
Objective To explore the effects of cefoperazone sulbactam combined with budesonide inhalation on bacterial clearance effect,ventilation function,inflammatory factor in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)induced by bacterial infection.Methods A prospective study was conducted on 70 elderly patients with AECOPD caused by bacterial infection who were treated in the Third Hospital of Changsha from January 2022 to December 2023.According to the random number table method,they were divided into the control group(n=35)and the observation group(n=35).The control group was given routine therapy and budesonide inhalation,while observation group was additionally treated with cefoperazone sulbactam.The response rates of treatment,bacterial clearance rates,ventilation function[peak expiratory flow(PEF),forced vital capacity(FVC),forced expiratory volume in one second(FEV1)],serum inflammatory fac-tor[procalcitonin(PCT)and interleukin-6(IL-6)]before treatment and after 14 days of treatment and the occurrence of adverse reactions in the two groups were compared.Results The effective rate of treatment in the observation group was 94.29％,which was higher than that in the control group(77.14％),and the difference was statistically significant(P＜0.05).The bacterial clearance rate of the observation group was 93.75％,which was higher than that of the control group(78.26％),and the difference was statistically significant(P＜0.05).After 14 days of treatment,the PEF,FVC and FEV1 of the two groups were higher than those before treatment,and the PEF,FVC and FEV1 of the observation group were(3.72±0.75)L/s,(2.31±0.32)L and(1.42±0.41)L,respectively,which were higher than those of the control group[(3.19±0.59)L/s,(2.05±0.28)L,(1.10±0.37)L],the differences were statistically significant(P＜0.05).After 14 days of treat-ment,the levels of PCT and IL-6 in the two groups were lower than those before treatment,and the levels of PCT and IL-6 in the observation group were(1.12±0.38)ng/mL and(23.16±5.53)ng/L,respectively,which were lower than those in the control group[(1.47±0.45)ng/mL,(29.48±5.74)ng/L],the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of total adverse reactions between the observation group and the control group(8.57％vs.5.71％)(P＞0.05).Conclusion The application effect of cefoperazone sulbactam combined with budesonide inhalation is good in elderly patients with AECOPD induced by bacterial in-fection,which can improve the ventilation function of patients,inhibit inflammatory factors,improve curative effect,with good safety.
维普
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