【摘要】 目的探讨吸入用复方异丙托溴铵溶液对慢性阻塞性肺疾病急性加重期(AECOPD)老年患者血浆脑钠肽(BNP)浓度的影响。方法将我院呼吸内科住院治疗的中重度AECOPD老年患者71例随机分为2组。对照组35例应用吸氧,抗生素抗感染,氨溴索、多索茶碱、糖皮质激素平喘等常规治疗措施;观察组36例在常规治疗基础上加用复方异丙托溴铵溶液2.5m L雾化吸入,bid。观察治疗前及治疗1周后2组患者的肺功能、呼吸困难评分、血浆BNP浓度及左室射血分数(LVEF),并评价临床疗效。结果治疗后观察组临床疗效明显优于对照组(P<0.05),呼吸困难评分和血浆BNP浓度明显低于对照组(P<0.01),而肺功能指标1秒钟用力呼气容积与预计的百分率(FEV1%)和LVEF明显高于对照组(P<0.01)。结论吸入用复方异丙托溴铵溶液雾化吸入可显著改善AECOPD老年患者肺功能,缓解呼吸困难,降低心力衰竭发生的危险性,改善预后,其机制可能与血浆BNP浓度降低有关。更多还原

【Abstract】 AIM To investigate the effects of compound ipratropium bromide inhalation solution on acute exacerbation of chronic obstructive pulmonary disease( AECOPD) in elderly patients. METHODS A total of 71 patients of AECOPD were randomly divided into 2 groups,the observation group with 36 patients and the control group with 35 patients. All patients were given conventional low-flow oxygen,antibiotics to control infection,ambroxol,doxofylline,glucocorticoid and intravenous infusion diprophylline in control group. The observation group was given compound ipratropium bromide 2. 5 m L( atomizing inhalation,2 times a day) plus the conventional therapy.The lung function,dyspnea scores,plasma brain natriuretic peptide( BNP) concentrations and left ventricular ejection franction( LVEF) changes were compared between 2 groups after a week. RESULTS In the observation group,dyspnea scores and plasma BNP concentrations were significantly lower than the control group( P < 0. 01),while LVEF and the forced expiratory volume in one second / predicted value ratio( FEV1%) were significantly higher than the control group( P < 0. 01). CONCLUSION Compound ipratropium bromide inhalation solution can significantly alleviate the symptoms of dyspnea,improve lung function,decrease BNP concentrations and the risk of heart failure,and improve the prognosis of AECOPD in elderly patients.更多还原