本文選題：地塞米松 + 頭孢呋辛鈉��； 參考：《中國藥房》2016年36期

【摘要】：目的:探討地塞米松聯(lián)合頭孢呋辛鈉治療慢性阻塞性肺疾病急性加重期(AECOPD)合并肺氣腫的療效和安全性。方法:回顧性收集80例AECOPD合并肺氣腫患者資料,按照用藥不同分為觀察組和對照組,每組40例。兩組患者入院后均立即臥床休息,并給予營養(yǎng)支持、維持電解質平衡等對癥支持治療,與此同時,對照組患者給予注射用頭孢呋辛鈉1.5 g加入0.9%氯化鈉注射液100 ml中靜脈滴注,bid(若抗感染效果不佳則增加劑量至2.0 g);觀察組患者在對照組治療基礎上加用地塞米松磷酸鈉注射液5 mg加入0.9%氯化鈉注射液20 ml中霧化吸入,bid。兩組患者均連續(xù)治療1周。觀察兩組患者治療前后肺功能相關指標,包括6min步行距離(6MWT)、肺活量(FVC)、第1秒用力呼氣容積(FEV1)、FEV1/FVC、呼氣中斷流速(MMEF)以及最高呼氣流速(PEF)水平;炎癥細胞因子水平,包括多形核白細胞(PMN)、白細胞介素(IL)-8、IL-17、超敏C反應蛋白(hs-CRP)和腫瘤壞死因子(TNF)-α水平;氣管阻力相關指標,包括呼吸總阻抗(Z5)、共振頻率(Fres)和總氣管阻力(R5)水平;肝、腎功能指標,包括丙氨酸轉氨酶(ALT)、天冬氨酸轉氨酶(AST)、尿素氮(BUN)、血肌酐(Scr)和尿肌酐(Ucr)水平。結果:治療前兩組患者肺功能相關指標、炎癥細胞因子水平和氣管阻力相關指標比較差異均無統(tǒng)計學意義(P0.05)。治療后,兩組患者肺功能相關指標顯著高于同組治療前,且觀察組高于對照組,炎癥細胞因子水平和氣管阻力相關指標均顯著低于同組治療前,且觀察組低于對照組,差異均有統(tǒng)計學意義(P0.05)。安全性方面,兩組患者治療前后肝、腎功能指標均在正常范圍內。結論:地塞米松聯(lián)合頭孢呋辛鈉治療AECOPD合并肺氣腫療效較好,可明顯改善患者的肺功能,降低患者的炎癥反應和氣管阻力,且安全性較好。
[Abstract]:Objective: to investigate the efficacy and safety of dexamethasone combined with cefuroxime sodium in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) with emphysema.Methods: 80 cases of AECOPD complicated with emphysema were collected retrospectively and divided into observation group and control group.The two groups were all in bed immediately after admission, and were given nutritional support, electrolyte balance and other symptomatic support treatment, at the same time,Patients in the control group were given 1.5 g cefuroxime sodium for injection plus 0.9% sodium chloride 100ml intravenous infusion of bidbidae (if the anti-infective effect was not good, the dose was increased to 2.0 g / g), while the patients in the observation group were treated with dexamethasone on the basis of the treatment in the control group.Sodium phosphate injection (5 mg) was added to 0.9% sodium chloride injection (20ml).The patients in both groups were treated continuously for 1 week.Pulmonary function related indexes were observed before and after treatment, including 6min walking distance (6MWTT), vital capacity (VV), FEV1 / FVC (FEV1 / FEV1 / FEV1), peak expiratory flow (MPEF) and peak expiratory flow (PEF), and inflammatory cytokines.These include polymorphonuclear leukocyte (PMN), interleukin-8 (IL-17), hypersensitive C-reactive protein hs-CRP (hs-CRP) and tumor necrosis factor- 偽 (TNF- 偽) levels; tracheal resistance-related parameters, including total respiratory impedance, resonance frequency (Fres5) and total trachea resistance (R5); liver and renal function.These include alanine aminotransferase (alt), aspartate transaminase (AST), urea nitrogen bun (bun), serum creatinine (SCR) and urinary creatinine (Ucrs).Results: there were no significant differences in pulmonary function, inflammatory cytokines and tracheal resistance between the two groups before treatment.After treatment, the pulmonary function related indexes in both groups were significantly higher than those before treatment in the same group, and the levels of inflammatory cytokines and tracheal resistance in the observation group were significantly lower than those in the control group, and the levels of inflammatory cytokines and tracheal resistance in the observation group were significantly lower than those in the control group.The difference was statistically significant (P 0.05).In terms of safety, the liver and kidney function indexes of both groups were within normal range before and after treatment.Conclusion: dexamethasone combined with cefuroxime sodium is effective in the treatment of AECOPD with emphysema.
【作者單位】： 南通市第二人民醫(yī)院藥劑科;南通市第二人民醫(yī)院呼吸科;
【分類號】：R563

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