摘要目的:研究莫西沙星联合舒利迭吸入疗法在慢性阻塞性肺疾病急性发作(AECOPD)时的临床疗效,及其对血清淀粉样蛋白A(SAA)、转化生长因子-β1(TGF-β1)、和素肽(copeptin)、可溶性细胞间黏附因子-1(sICAM-1)的影响。方法:本实验选取我院2015年12月至2016年12月收治的102例AECOPD病患为研究对象,随机分为对照组及实验组,每组51例。对照组在接受常规治疗的基础上予舒利迭联合阿莫西林-克拉维酸吸入治疗,实验组基于对照组基础治疗加上莫西沙星联合舒利迭吸入治疗。比较两组临床疗效,观察血清SAA,TGF-β1,copeptin,sICAM-1水平变化,动脉血血气分析二氧化碳分压(PaCO2)及氧分压(PaO2),检测肺功能:第1秒用力呼气容积(FEV1)、肺活量(FVC)及FEV1/FVC,评估COPD患者生存质量及呼吸困难程度:改良呼吸困难评分(Medical Research Council Dyspnoea Scale, mMRC)、慢阻肺评估测试(COPD Assessment Test, CAT),和发生不良反应的情况。结果:治疗后,实验组有效率(92.16%)显著高于对照组,差异有统计学意义(P<0.05)。两组肺功能检测:FEV1、FCV、FEV1/FCV,治疗后均有所改善,差异有统计学意义(P<0.05),且实验组较对照组改善更多(P<0.05)。两组动脉血气分析比较,治疗后,PaO2有明显上升(P<0.05),且实验组高于对照组,差异均有统计学意义(P<0.05)。治疗前后两组患者生存质量及呼吸困难分级评估,治疗后均明显改善,差异有统计学意义(P<0.05),且实验组明显低于对照组(P<0.05),差异有统计学意义。两组不良反应比较无差异(P>0.05)。结论:莫西沙星联合舒利迭吸入对AECOPD患者的临床疗效肯定,能够降低血清SAA、TGF-β1、copeptin、sICAM-1浓度,改善动脉血氧分压、患者生存质量及肺功能。
Abstract：Objective: To study the clinical efficacy of moxifloxacin combined seretide inhalation in acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and its effects on serum amyloid A (SAA), transforming growth factor-β1 (TGF -β1), copeptin, soluble intercellular adhesion factor-1 (sICAM-1). Methods: A total of 102 AECOPD patients were enrolled of our hospital from December 2015 to December 2016. They were randomly divided into control group and experimental group (n = 51). The control group was treated with seretide combined Amoxicillin - clavulanic acid inhalation on the basis of routine treatment. The experimental group was treated with moxifloxacin combined seretide inhalation. To compare the changes of serum SAA, TGF-β1, copeptin and sICAM-1 in two groups, to observe the changes of serum CO2A (PaCO2) and oxygen partial pressure (PaO2), and to detect lung function: (FEV1), vital capacity (FVC) and FEV1 / FVC were used to assess the quality of life and dyspnea of patients with COPD: Medical Research Council Dyspnoea Scale( mMRC), COPD Assessment Test( CAT), and adverse events. Results: After treatment, the effective rate (92.16%) in the experimental group was significantly higher than that in the control group (P <0.05). FEV1, FCV, FEV1 / FCV were improved after treatment, the difference was statistically significant (P <0.05), and the experimental group improved more than the control group (P <0.05). Compared with the control group, the difference was statistically significant (P <0.05). The PaO2 of the two groups was significantly higher than that of the control group (P <0.05)., and the experimental group was significantly lower than the control group (P <0.05), the difference was statistically significant (P <0.05), and the difference was statistically significant (P <0.05). There was no significant difference between the two groups (P> 0.05). Conclusion: The clinical efficacy of moxifloxacin combined seretide inhalation on AECOPD patients can reduce serum SAA, TGF-β1, copeptin, sICAM-1 levels, improve arterial oxygen pressure, quality of life and lung function.
2018, Vol. 24 
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