标题：氨茶碱联合布地奈德福莫特罗对AECOPD患者氧化应激及肺功能的影响

      作者：李静 1，林忠贤 2，周国红 2    中信惠州医院有限公司中信惠州医院药房 1、呼吸科 2，广东 惠州 516001

      卷次： 2020年31卷2期

      【摘要】 目的 探讨氨茶碱联合布地奈德福莫特罗对慢性阻塞性肺疾病急性加重期(AECOPD)患者氧化应激及肺功能的影响。方法 选取2017年1月至2019年2月中信惠州医院有限公司中信惠州医院呼吸科收治的80例AECOPD患者进行研究，按随机数表法分为观察组和对照组，每组40例，对照组在常规疗法基础上给予布地奈德福莫特罗治疗，观察组在对照组治疗基础上联合氨茶碱注射液治疗，两组患者均连续治疗4周。比较两组患者治疗后的症状改善情况、血气指标、氧化应激、肺功能的变化和不良反应。结果 治疗后，观察组和对照组患者的咳嗽消失时间[(14.58±1.73) d vs (18.83±2.42) d]、咳痰消失时间[(13.78±2.41) d vs (16.69±3.87) d]、心悸消失时间[(18.51±2.40) d vs(23.94±3.52) d]和喘息消失时间[(16.47±2.72) d vs (18.98±3.26) d]比较，观察组明显快于对照组，差异均有统计学意义(P<0.05)；观察组和对照组患者的动脉氧分压(PaO2) [(78.46±6.73) mmHg vs (72.33±7.94) mmHg]、血氧饱和度(SpO2)[(86.55±12.31) % vs (78.57±13.62)%]比较，观察组明显高于对照组，动脉二氧化碳(PaCO2) [(34.48±8.62) mmHg vs(44.63±6.26) mmHg]比较，观察组明显低于对照组，差异均有统计学意义(P<0.05)；观察组和对照组患者的丙二醛(MDA) [(5.38±1.58) μmol/L vs (8.18±1.36) μmol/L]比较，观察组明显低于对照组，超氧化物歧化酶(SOD) [(103.36±10.85) U/mL vs (91.66±11.52) U/mL、谷胱甘肽过氧化物酶(GSH-Px) [(185.32±14.67) U/L vs (150.13±12.94) U/L]比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)；观察组和对照组患者的第一秒最大呼气容积(FEV1)[(1.62±0.49) L vs (1.28±0.43) L]、FEV1与用力肺活量比值(FEV1/FVC) [(71.54±7.82)% vs (65.61±6.35)%]、最大呼气流量(PEF) [(3.91±1.15) L/s vs (3.24±0.73) L/s]比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)；观察组和对照组不良反应总发生率分别为7.50%和10.00%，差异无统计学意义(P>0.05)。结论 与单独用药相比，氨茶碱联合布地奈德福莫特罗可有效改善AECOPD患者的氧化应激指标，促进肺功能恢复，具有较高的临床应用价值。
      【关键词】 氨茶碱；布地奈德雾；慢性阻塞性肺疾病急性加重期；氧化应激；肺功能
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2020）02—0167—04

Effect of aminophylline combined with budesonide on oxidative stress and pulmonary function of patients withacute exacerbations of chronic obstructive pulmonary disease.
LI Jing 1, LIN Zhong-xian 2, ZHOU Guo-hong 2.Department of Pharmacy 1, Department of Respiratory 2, CITIC Huizhou Hospital of CITIC Huizhou Hospital Co., Ltd.Huizhou 516001, Guangdong, CHINA
【Abstract】 Objective To explore the curative efficacy of aminophylline combined with budesonide in the treat-ment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and the effect on oxidative stress andpulmonary function. Methods A total of 80 patients with AECOPD, who admitted to Department of Respiratory, CIT-IC Huizhou hospital of CITIC Huizhou Hospital Co., Ltd from January 2017 to February 2019 were selected and dividedinto the observation group and control group according to random number table method, with 40 patients in each group.The control group was treated with budesonide on the basis of routine treatment, while the observation group was treatedwith aminophylline injection on the basis of the treatment of the control group, all for 4 weeks. After treatment, the im-provement of symptoms, blood gas index, oxidative stress, changes of pulmonary function, and adverse reactions of thetwo groups were compared. Results After treatment, the disappearance times of cough, sputum, palpitation, and wheez-ing were (14.58±1.73) d, (13.78±2.41) d, (18.51±2.40) d, (16.47±2.72) d in the observation group, respectively, whichwere significantly shorter than corresponding (18.83±2.42) d, (16.69±3.87) d, (23.94±3.52) d, (18.98±3.26) d in the con-trol group (all P<0.05); the arterial oxygen partial pressure (PaO2), blood oxygen saturation (SpO2), partial pressure ofcarbon dioxide in arterial blood (PaCO2) in the observation group were (78.46±6.73) mmHg, (86.55±12.31)%, (34.48±8.62) mmHg, respectively, which were significantly higher than corresponding (72.33 ± 7.94) mmHg, (78.57 ± 13.62)% ,(44.63 ± 6.26) mmHg in control group (all P<0.05); malondialdehyde (MDA) in the observation group was (5.38 ±1.58) μmol/L versus (8.18±1.36) μmol/L in the control group (P<0.05); superoxide dismutase (SOD) and glutathione per-oxidase (GSH-Px) in the observation group were (103.36±10.85) U/mL and (185.32±14.67) U/L, respectively, whichwere significantly higher than corresponding (91.66±11.52) U/mL and (150.13±12.94) U/L in the control group (all P<0.05); the forced expiratory volume in one second (FEV1), ration of FEV1 to forced vital capacity (FVC), peak expirato-ry flows (PEF) in the observation group were (1.62±0.49) L, (71.54±7.82)%, (3.91±1.15) L/s, respectively, which were