【摘要】 目的观察克拉霉素联合噻托溴铵对老年慢性阻塞性肺疾病(COPD)患者急性加重期降钙素原、C反应蛋白水平的影响。方法选取2014年10月~2015年1月于辽宁省抚顺市中心医院就诊的急性加重期老年COPD患者60例,将其随机分为观察组和对照组,每组各30例。对照组患者接受噻托溴铵粉雾剂治疗,观察组患者在此基础上接受克拉霉素口服治疗。观察比较两组患者的血降钙素原、C反应蛋白水平及肺功能[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)]改善情况和副作用发生情况。结果两组血中降钙素原、C反应蛋白水平的组间效应、时间效应及交互作用差异均有统计学意义(P<0.05)。治疗后10、20 d,两组血中降钙素原、C反应蛋白水平均较入院时显著降低,且治疗后20 d低于治疗后10 d,差异均有统计学意义(P<0.05)。观察组治疗后10、20 d血中降钙素原、C反应蛋白水平显著低于对照组(P<0.05)。治疗后,两组FEV1、FEV1/FVC均较治疗前明显提高(P<0.05),且观察组明显高于对照组(P<0.05)。两组患者均未出现严重不良反应。结论噻托溴铵联合克拉霉素对老年COPD患者急性加重期内降钙素原以及C反应蛋白表达水平有显著的影响,能明显提高患者肺功能,值得在临床上推广应用。更多还原

【Abstract】 Objective To observe the effects of Clarithromycin combined with Tiotropium Bromide for the levels of procalcitonin, C reactive protein in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods Sixty elderly patients with acute exacerbation of COPD treated in Fushun Central Hospital of Liaoning Province from October 2014 to January 2015 were selected and randomly divided into observation group and control group, with 30 cases in each group. The control group received Tiotropium Bromide Dry Powder Inhalation, on basis of which, the observation group received Clarithromycin orally. The improvement of levels of procalcitonin, C reactive protein and lung function [forced expiratory volume in the first second(FEV1), the percentage of forced expiratory volume in the first second accounted for forced vital capacity(FEV1/FVC)] and the conditions of side effects of the two groups were observed and compared. Results There were statistically significant differences of effects between groups, time effects and interaction effects of procalcitonin, C reactive protein in the two groups(P < 0.05). After treatment for 10, 20 d, the levels of procalcitonin, C reactive protein in the two groups were all lower than those on admission, which after treatment for 20 d were lower than those after treatment for 10 d, the differences were all statistically significant(P < 0.05).After treatment for 10, 20 d, the levels of procalcitonin, C reactive protein in the observation group were significantly lower than those of control group(P < 0.05). After treatment, the levels of FEV1, FEV1/FVC in the two groups were all higher than those before treatment(P < 0.05), which of observation group was higher than that of control group(P < 0.05).Both groups had no serious adverse reactions. Conclusion Clarithromycin combined with Tiotropium Bromide has significant effects on the levels of procalcitonin and C reactive protein expression in elderly patients with acute exacerbation of COPD, which can improve the pulmonary function of patients, thus it is worthy of promotion and application in clinic.更多还原