目的 探討厄多司坦分散片聯(lián)合硫酸沙丁胺醇吸入氣霧劑治療慢性阻塞性肺疾?。–OPD）的療效及對血清因子的影響。方法 選擇2018年5月—2020年5月在南陽南石醫(yī)院治療的126例COPD患者，根據(jù)用藥的差別分為對照組（63例）和治療組（63例）。對照組吸入硫酸沙丁胺醇吸入氣霧劑，2撳/次，2次/d；治療組在對照組的基礎(chǔ)上口服厄多司坦分散片，0.3 g/次，2次/d。兩組患者經(jīng)2周治療。觀察兩組患者臨床療效，比較治療前后兩組患者動脈血氣指標(biāo)、肺功能、APACHE Ⅱ評分、mMRC評分、CPIS評分、Murray肺損傷評分，及血清降鈣素原（PCT）、血管性血友病因子（vWF）、白細(xì)胞介素-18（IL-18）、高遷移率族蛋白B1（HMGB1）、單核細(xì)胞趨化蛋白1（MCP-1）和腫瘤壞死因子-α（TNF-α）水平。結(jié)果 經(jīng)治療，對照組有效率為82.54%，顯著低于治療組的96.83%（P<0.05）。經(jīng)治療，兩組pO₂和SaO₂顯著升高（P<0.05），而pCO₂顯著降低（P<0.05），且治療組改善最明顯（P<0.05）。經(jīng)治療，兩組50%最大呼氣流速（PEF50）、第1秒末用力呼氣量（FEV1）、最大呼氣壓（PEMAX）、最大口腔吸氣壓（PIMAX）均明顯升高，且治療組明顯高于對照組（P<0.05）。經(jīng)治療，兩組APACHE Ⅱ評分、mMRC評分、CPIS評分、Murray肺損傷評分均顯著降低，且治療組降低更明顯（P<0.05）。經(jīng)治療，兩組血清PCT、vWF、IL-18、HMGB1、MCP-1、TNF-α水平均明顯下降（P<0.05），且治療組明顯低于對照組（P<0.05）。結(jié)論 厄多司坦分散片聯(lián)合硫酸沙丁胺醇吸入氣霧劑治療COPD可有效改善肺功能和動脈血氣指標(biāo)，降低機體炎癥反應(yīng)，降低APACHE Ⅱ評分、mMRC評分、CPIS評分、Murray肺損傷評分。

Objective To investigate the efficacy of Erdostine Dispersible Tablets combined with salbutamol sulfate in treatment of chronic obstructive pulmonary disease and its effect on serum factors. Methods Patients (126 cases) with chronic obstructive pulmonary disease in Nanyang Nanshi Hospital from May 2018 to May 2020 were divided into control (63 cases) and treatment (63 cases) groups based on different treatments. Patients in the control group were administered with Salbutamol Sulfate Inhalation Aerosol, 2 press/time, twice daily. Patients in the treatment group were po administered with Erdostine Dispersible Tablets on the basis of the control group, 0.3 g/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the arterial blood gas indexes, pulmonary function, APACHE Ⅱ scores, mMRC scores, CPIS scores, Murray scores, and the serum levels of PCT, vWF, IL-18, HMGB1, MCP-1, and TNF-α in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 82.54%, which was significantly lower than that of 96.83% in the treatment group (P<0.05). After treatment, pO₂ and SaO₂ increased significantly (P<0.05), while pCO₂ decreased significantly in both groups (P<0.05), and the improvement was the most obvious in the treatment group (P<0.05). After treatment, PEF50, FEV1, PEMAX and PIMAX in both groups were significantly increased (P<0.05), and those in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, APACHE Ⅱ score, mMRC score, CPIS score and Murray lung injury score in both groups were significantly decreased (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of PCT, vWF, IL-18, HMGB1, MCP-1 and TNF-α in the two groups were significantly decreased (P<0.05), and which in the treatment group was significantly lower than those in the control group (P<0.05). Conclusion Erdostatin Dispersible Tablets combined with Salbutamol Sulfate Inhalation Aerosol in the treatment of chronic obstructive pulmonary disease can effectively improve pulmonary function and arterial blood gas index, reduce inflammatory response, reduce APACHE Ⅱ score, mMRC score, CPIS score and Murray lung injury score.

R974

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（201403258）