| 摘要: |
| ［摘要］目的 探讨大剂量盐酸氨溴索在慢性阻塞性肺疾病急性加重（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者治疗中的价值．方法 选取60例中、重度AECOPD住院患者为研究对象，随机分为治疗组和对照组，对照组给予抗炎、氧疗、平喘等常规治疗，治疗组在常规治疗的基础上给予盐酸氨溴索静滴，测定2组治疗前、治疗10 d及20 d血清中丙二醛（malonaldehyde，MDA）、谷胱甘肽还原酶（glutathione reductase，GSH）、超氧化物歧化酶（superoxide dismutase，SOD）含量以及FEV1%pre、呼吸困难评分等．比较2组治疗效果．结果 治疗组治疗10 d、20 d测定的MDA较治疗前均有降低、GSH及SOD含量较治疗前均有升高，治疗20 d测定的MDA较治疗10 d的含量有降低、GSH及SOD含量较治疗10 d的含量有升高，差异均有统计学意义（P＜0.05）．治疗组治疗10 d、20 d测定的FEV1%pre较治疗前以及治疗20 d较治疗10 d测定的FEV1%pre高，差异均有统计学意义（P＜0.05）．治疗组治疗10 d、20 d较治疗前的测定的呼吸困难评分以及治疗20 d较治疗10 d测定的呼吸困难评分均有降低，差异均有统计学意义（P＜0.05）．治疗组和对照组在治疗后10 d与治疗前差值、治疗后20 d与治疗前差值、治疗20 d与10 d后的MDA、GSH、SOD、FEV1%pre差值以及治疗20 d与10 d后呼吸困难评分差值方面，差异均有统计学意义（P＜0.05）．治疗组的住院天数为（11.13±1.94）d，对照组的住院天数为（13.50±2.06）d，治疗组的平均住院天数较对照组短，差异有统计学意义（P＜0.05）．治疗组仅2例患者出现轻微胃肠道反应，经处理后症状缓解．结论 大剂量盐酸氨溴索能提高AECOPD患者抗氧化能力、减轻氧化应激程度，同时改善患者肺功能，缩短住院天数，不良反应少． |
| 关键词: ［关键词］盐酸氨溴索 慢性阻塞性肺疾病急性加重 治疗 |
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| 基金项目:［基金项目］昆明市第一人民医院院内基金资助项目（2011kjc01） |
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| The Value of Large Dose of Ambroxol Hydrochloride in Treating Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
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CHEN Min
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（The 2nd Dept of Respiratory Medicine，The First People’s Hospital of Kunming，Kunming Yunnan 650011，China）
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| Abstract: |
| ［Abstract］Objective To explore the value of large dose of ambroxol hydrochloride in treating patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods Sixty hospitalized patients with moderate-to-severe AECOPD were dived into treatment group and control group at random. The control group was given routine therapy which contained anti-inflammatory，oxygen therapy， antiasthmatic therapy and so on. The treatment group was given ambroxol hydrochloride intravenous drip therapy on basis of the routine therapy. The malonaldehyde（MDA），glutathione reductase（GSH），superoxide dismutase（SOD），FEV1%pre， dyspnea score and so on were measured before and ten days，twenty days after treatment in two groups. The outcomes of two groups were compared. Results In the treatment group，the content of MDA of treatment after treatment ten days and twenty days was lower， the content of GSH and SOD were higher than before treatment；the content of MDA of after treatment twenty days was decreased，the content of GSH and SOD were higher than after treatment ten days， the difference had statistical significance（P＜0.05）. In the treatment group， the FEV1 % pre of after treatment ten days and twenty days were higher than before treatment，the FEV1 % pre of after treatment twenty days were higher than after treatment ten days， the difference had statistical significance（P＜0.05）. In the treatment group，the dyspnea score of after treatment ten days and twenty days was decreased than before treatment，the dyspnea score of after treatment twenty days was decreased than after treatment ten days，the difference had statistical significance（P＜0.05）.The difference of MDA，GSH，SOD，FEV1%pre between after treatment ten days and before treatment, between after treatment twenty days and before treatment, between after treatment ten days and twenty days, and the difference of dyspnea score between after treatment ten days and twenty days in the treatment group and control group all had statistical significance（P＜0.05） .Hospitalized days of the treatment group was（11.13±1.94 ）days，that of the control group was（13.50± 2.06）days， the average hospitalized days of the treatment group was shorter than the control group，the difference was statistically significance（P＜0.05）. In treatment group，only two patients had mild gastrointestinal reaction which was relieved after treatment. Conclusion Large dose of ambroxol hydrochloride can increase antioxidative ability， reduce oxidative stress degree of patients with AECOPD， meanwhile can improve patients′ pulmonary function and shorten hospitalized days. |
| Key words: ［Key words］Ambroxol hydrochloride AECOPD Treatment |