章超

[摘要] 目的 探討布地奈德联合氨溴索治疗对慢性阻塞性肺疾病（chronic obstructive pulmonary，COPD）患者中性粒细胞/淋巴细胞比值（NLR）、C反应蛋白（C reactive protein，CRP）水平及血气指标的影响。 方法 选取2017年1月～2018年12月呼吸内科因COPD收治住院的64例患者作为研究对象，并据随机数字表法分为研究组与对照组，各32例。对照组在常规治疗基础上给予布地奈德雾化吸入治疗，观察组在对照组基础上给予盐酸氨溴索静脉滴注治疗。比较两组疗效并观察治疗前后NLR、CRP、血气分析及症状改善时间等情况。 结果 经有效治疗后，研究组临床总有效率为87.50%，与对照组治疗总有效率（65.62%）相比，差异有统计学意义（P<0.05）;治疗前，两组患者NLR、CRP、血气分析水平比较，差异无统计学意义（P>0.05）;治疗后，两组患者NLR、CRP水平及动脉血二氧化碳分压（PaCO2）显著下降，pH值和动脉血氧分压（PaO2）水平均显著上升，且研究组与对照组相比，差异均有统计学意义（P<0.05）;研究组气促、咳嗽、咳痰缓解时间较对照组显著下降，差异均有统计学意义（P均<0.05）。结论 对COPD急性加重期患者应用布地奈德联合氨溴索治疗疗效显著，有助于减轻气道炎症反应，降低炎症指标水平，改善肺功能及动脉血气指标，改善临床症状，值得临床推广应用。

[关键词] 慢性阻塞性肺疾病;布地奈德;氨溴索;CRP;NLR;血气指标

[中图分类号] R563.9          [文献标识码] B          [文章编号] 1673-9701（2020）16-0115-03

The effect of the therapy of budesonide combined with ambroxol hydrochloride on NLR， CRP levels and blood gas indexes in peripheral blood of patients with chronic obstructive pulmonary disease

ZHANG Chao

Department of Pharmacy， Jiujiang First People's Hospital in Jiangxi Province， Jiujiang   332000， China

[Abstract] Objective To explore the effect of the therapy of budesonide combined with ambroxol hydrochloride on neutrophil/lymphocyte ratio （NLR）， C reactive protein （CRP） levels and blood gas indexes of patients with chronic obstructive pulmonary disease （COPD）. Methods 64 patients hospitalized for COPD in Department of Respiratory Medicine admitted to our hospital from January 2017 to December 2018 were selected as research subjects and divided into the study group and the control group through random number table method， with 32 patients in each group. The control group was treated with budesonide atomization inhalation on the basis of conventional treatment， while the observation group was treated with ambroxol hydrochloride intravenous drip on the basis of the control group. The efficacy was compared between the two groups and the conditions such as NLR， CRP， blood gas analysis and symptom improvement time before and after treatment were observed. Results After effective treatment， the total clinical effective rate in the study group was 87.50%， different from 65.62% in the control group， and the difference was statistically significant（P<0.05）. Before treatment， there was no statistically significant difference in the analysis of NLR， CRP levels and results of blood gas between the two groups（P>0.05）.After treatment， the NLR and CRP levels and level of partial pressure of carbon dioxide in artery（PaCO2） decreased significantly in the two groups， while the pH value and level of partial pressure of artery（PaO2） increased significantly， and the differences between the study group and the control group were statistically significant（P<0.05）. The anhelous time， cough time and expectoration relief time in the study group were significantly shorter than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion Budesonide combined with ambroxol is significantly effective in treating patients with acute exacerbation of COPD， which is conducive to reducing airway inflammatory reaction， lowering inflammatory index level，improving pulmonary function and arterial blood gas index， and ameliorating clinical symptoms. It is worthy of clinical promotion.

[Key words] Chronic obstructive pulmonary disease（COPD）; Budesonide; Ambroxol; CRP; NLR; Blood gas indexes

慢性阻塞性肺疾病是一种以气流受限为特征的呼吸系统炎症性慢性疾病[1]。其临床表现为咳嗽、咳痰、胸闷气喘，患者肺功能明显受损。有研究显示，我国COPD患者大约有3000万以上，主要为中老年人[2]。由于中国即将迈入老年社会，COPD发病率及病死率逐年上升，已经成为一个重要的公共卫生问题，严重影响患者的生活质量。目前临床上COPD主要以药物治疗，患者一旦发病病情可直线加重，严重者甚至缺氧而危机生命，因此及时有效的减轻患者症状、缓解炎症及改善肺功能至关重要。本研究主要探讨布地奈德联合氨溴索治疗对慢性阻塞性肺疾病患者NLR、CRP水平及血气指标的影响，现报道如下。……