大剂量氨溴索对老年慢性阻塞性肺疾病合并呼吸衰竭患者C反应蛋白、氧化应激反应、血气分析及呼吸功能的影响

摘要

目的 分析大剂量氨溴索对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者C反应蛋白(CRP)、氧化应激反应、血气分析及呼吸功能的影响.方法 选取100例老年COPD合并呼吸衰竭患者,随机分为观察组和对照组各50例.2组患者入院后均给予常规对症治疗和机械通气治疗,对照组患者给予常规剂量盐酸氨溴索注射液静脉滴注,观察组患者给予大剂量盐酸氨溴索注射液静脉滴注.2组患者均连续治疗7d.比较2组患者治疗前及治疗7d的动脉血气分析指标、血清CRP及氧化应激反应指标、呼吸功能指标.比较2组患者治疗期间的呼吸机相关肺炎(VAP)发生率和机械通气时间.结果 2组患者治疗前的动脉血气分析指标、血清CRP及氧化应激反应指标、呼吸功能指标的差异均无统计学意义(P＞0.05);治疗后,2组患者的上述指标均较治疗前显著改善(P＜0.05),且观察组患者治疗后的上述指标均显著优于对照组(P＜0.05).观察组患者的VAP发生率和机械通气时间均显著低于对照组(P＜0.05).结论 在COPD合并呼吸衰竭患者的治疗中应用大剂量氨溴索能够显著改善患者的血氧状态和呼吸功能,缓解和降低炎症反应和氧化应激反应,减少VAP的发生,缩短机械通气时间.%Objective To analyze the effects of large dose ambroxol on the C reactive protein (CRP),oxidative stress reactions,blood gas analysis and respiratory functions in the elderly patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure.Methods A total of 100 elderly patients with COPD and respiratory failure were selected and randomly divided into observation group and control group,50 cases in each group.The patients in both groups were treated with the routine treatment and mechanical ventilation treatment after hospital admission.The patients in the control group were treated with routine dose intravenous infusion of ambroxol hydrochloride injection,while the patients in the observation group were treated with large dose intravenous infusion of ambroxol hydrochloride injection.The patients in the both groups were treated for 7 days.The arterial blood gas analysis indicators,the serum CRP and the oxidative stress reactions indicators,and the respiratory functions indicators before the treatment and 7 days after the treatment were detected and compared between two groups.The incidence rate of the ventilator-associated pneumonia (VAP) during the treatment and the mechanical ventilation time were observed and compared between two groups.Results The levels of the arterial blood gas analysis indicators,the serum CRP and the oxidative stress reactions indicators,and the respiratory functions indicators before the treatment showed no significant differences between the two groups (P ＞0.05).After the treatment,the above indicators in both groups significantly improved (P ＜ 0.05),and the above indicators of the observation group after the treatment were significantly better than those in the control group (P ＜ 0.05).The incidence rate of VAP and the mechanical ventilation time of the observation group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Application of large dose ambroxol in the treatment of the patients with COPD and respiratory failure can improve the blood oxygen status and the respiratory function,alleviate the inflammation reactions and the oxidative stress reactions,reduce the incidence of VAP,and shorten the mechanical ventilation time.