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复方异丙托溴铵联合布地奈德吸入治疗慢性阻塞性肺疾病急性加重期及其对肝素结合蛋白的影响

Compound Ipratropium Bromide plus Budesonide Inhalation in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Effect on Heparin-Binding Protein.

作者信息

Dong Yuan, Li Qingling

机构信息

China University of Mining and Technology, Xuzhou First People's Hospital, No. 269, Daxue Road, Tongshan, Xuzhou 221000, Jiangsu, China.

出版信息

Evid Based Complement Alternat Med. 2022 Jul 4;2022:4457740. doi: 10.1155/2022/4457740. eCollection 2022.

Abstract

OBJECTIVE

To analyze the clinical effect of compound ipratropium bromide combined with budesonide atomization inhalation on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on the heparin-binding protein.

METHODS

A total of 110 patients with AECOPD who were admitted to our hospital between January 2020 and January 2021 were enrolled and assigned into control group (conventional treatment + compound ipratropium bromide) and combined group (conventional treatment + compound ipratropium bromide + budesonide) in a 1 : 1 ratio according to different treatment methods. The clinical effects, pulmonary function indexes, and heparin-binding protein levels before and after treatment were compared between the two groups.

RESULTS

The treatment with oxygen-driven nebulization of ipratropium bromide combined with budesonide led to a significantly higher total effective rate versus the treatment with ipratropium bromide alone ( < 0.001). After treatment, remarkably higher arterial oxygen partial pressure (PaO), arterial oxygen saturation (SaO), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC in the combined group vs. the control group were observed ( < 0.001). The carbon dioxide partial pressure (PaCO) levels in the two groups were significantly lower than those before treatment, and the decrease in the combined group was greater ( < 0.001). A significantl reduction was observed in heparin-binding protein in both groups after treatment, and the decrease in the combined group was greater versus the control group ( < 0.001).

CONCLUSION

Compound ipratropium bromide plus budesonide via aerosol inhalation therapy might be a preferable approach for AECOPD patients. It exhibits a synergistic effect on inhibiting inflammatory mediators and cytokine networks, significantly reduces airway hyperresponsiveness, and improves blood gas indicators and lung function.

摘要

目的

分析复方异丙托溴铵联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及其对肝素结合蛋白的影响。

方法

选取2020年1月至2021年1月我院收治的110例AECOPD患者,根据不同治疗方法按1∶1比例分为对照组(常规治疗+复方异丙托溴铵)和联合组(常规治疗+复方异丙托溴铵+布地奈德)。比较两组治疗前后的临床疗效、肺功能指标及肝素结合蛋白水平。

结果

异丙托溴铵联合布地奈德氧气驱动雾化吸入治疗的总有效率显著高于单用异丙托溴铵治疗(<0.001)。治疗后,联合组的动脉血氧分压(PaO)、动脉血氧饱和度(SaO)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及FEV1/FVC均显著高于对照组(<0.001)。两组二氧化碳分压(PaCO)水平均显著低于治疗前,且联合组下降幅度更大(<0.001)。两组治疗后肝素结合蛋白均显著降低,且联合组下降幅度大于对照组(<0.001)。

结论

复方异丙托溴铵联合布地奈德雾化吸入治疗可能是AECOPD患者的较好治疗方法。它在抑制炎症介质和细胞因子网络方面具有协同作用,能显著降低气道高反应性,改善血气指标和肺功能。

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