本文選題：慢性阻塞性肺疾病 + 多索茶堿　； 參考：《青海大學(xué)》2017年碩士論文

【摘要】：目的:本研究旨在探討應(yīng)用霧化吸入治療與在此基礎(chǔ)上加用多索茶堿的慢性阻塞性肺疾病患者TNF-a表達(dá)水平的差異,明確TNF-a與動(dòng)脈血?dú)庵笜?biāo)、肺功能的關(guān)系。為臨床合理用藥提供可靠的循證醫(yī)學(xué)證據(jù)。方法:選取我院入選慢性阻塞性肺疾病C、D組診斷標(biāo)準(zhǔn)患者,單純藥物組30例,給予霧化吸入硫酸沙丁胺醇溶液、布地奈德混懸液,聯(lián)合藥物組30例,在單純藥物組基礎(chǔ)上聯(lián)合應(yīng)用給予多索茶堿靜滴,兩組治療期均10天。采用ELISA法測(cè)定TNF-α濃度,并與肺功能及血?dú)夥治鲋笜?biāo)進(jìn)行相關(guān)性比較,統(tǒng)計(jì)分析檢測(cè)數(shù)據(jù)。結(jié)果:1.兩組患者血清TNF-a水平治療后較治療前均下降,有統(tǒng)計(jì)學(xué)意義(P0.05);治療后聯(lián)合藥物組與單純藥物組相比較TNF-a水平降低更為顯著,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組患者治療后的肺功能指標(biāo)(FEV1%pred、FVC%pred、PEF%pred、MMEF%pred)、血?dú)夥治鲋笜?biāo)(PaO_2、SaO_2、PaCO_2)較治療前均有改善(P0.05),治療后聯(lián)合藥物組與單純藥物組相比較肺功能、血?dú)夥治龈纳聘鼮轱@著,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.兩組患者治療前后血清TNF-a與PaCO_2呈正相關(guān)(P0.05),與FEV1%pred、FVC%pred、PEF%pred、MMEF%pred、PaO_2、SaO_2呈負(fù)相關(guān)(P0.05)。結(jié)論:1.隨著慢性阻塞性肺疾病患者炎癥的控制,其血清TNF-a的表達(dá)水平降低。2.多索茶堿聯(lián)合霧化吸入治療可明顯降低TNF-a水平,減輕肺損傷,糾正缺氧。3.患者血清TNF-a升高,說明其參與了慢性阻塞性肺疾病的氣道炎癥過反應(yīng)過程,并與肺功能受損有關(guān)。
[Abstract]:Objective: to investigate the difference of TNF-a expression between patients with chronic obstructive pulmonary disease (COPD) treated with atomization inhalation and doxofylline plus doxofylline, and to determine the relationship between TNF-a and arterial blood gas index and pulmonary function. To provide reliable evidence of evidence-based medicine for rational use of drugs in clinical practice. Methods: a total of 30 patients with chronic obstructive pulmonary disease (COPD) in group D were treated with aerosol inhalation of salbutamol sulfate and budesonide suspension, and 30 patients in the combined drug group were enrolled in the study, and 30 patients in the combined drug group were treated with nebulized salbutamol sulfate solution and budesonide suspension. Doxofylline was given intravenously on the basis of drug only in both groups for 10 days. The concentration of TNF- 偽 was measured by ELISA, and compared with pulmonary function and blood gas analysis. The result is 1: 1. The level of serum TNF-a in both groups was lower than that before treatment (P 0.05), and the level of TNF-a in the combined drug group was significantly lower than that in the simple drug group (P 0.05), the difference was statistically significant (P 0.05). After treatment, the pulmonary function indexes of both groups were improved by FEV1 pred and FVCCpredand PEFpredand MMEFpredg, the blood gas analysis index was P0.05, compared with that before treatment. After treatment, the pulmonary function in the combined drug group was better than that in the single drug group, and the difference was statistically significant (P 0.05P 0.05. 4) the difference was statistically significant (P 0.05P 0.05), and there was no significant difference between the two groups in blood gas analysis and blood gas analysis (P 0.05g. 4) after the treatment, the pulmonary function of the combined drug group was better than that of the control group (P 0.05%, P 0.05%, P 0.05%). There was a positive correlation between serum TNF-a and PaCO_2 before and after treatment in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups, and a negative correlation between serum TNF-a and PaCO_2 in both groups. Conclusion 1. With the control of inflammation in patients with chronic obstructive pulmonary disease, the expression of serum TNF-a decreased. 2. 2. Doxophylline combined with atomization inhalation can significantly reduce the level of TNF-a, alleviate lung injury, and correct hypoxia. 3. The increase of serum TNF-a in patients suggests that it is involved in the process of airway inflammatory overreaction in patients with chronic obstructive pulmonary disease and is related to the impairment of pulmonary function.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R563.9

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