目的 探討血必凈注射液聯(lián)合鹽酸氨溴索對老年重癥肺炎患者呼吸力學(xué)、血氣指標及細胞因子水平的影響。方法 選取2016年7月—2019年7月榆林市星元醫(yī)院80例老年重癥肺炎患者，根據(jù)隨機動態(tài)原則將受試者分為對照組40例和觀察組40例，對照組接受鹽酸氨溴索治療，觀察組接受血必凈注射液聯(lián)合鹽酸氨溴索治療，比較兩組的治療總有效率、治療前后呼吸力學(xué)、血氣指標及細胞因子等指標變化。結(jié)果 觀察組治療的總有效率為95.00%，顯著高于對照組的77.50%（P<0.05）。治療后兩組的平均氣道壓（mPaw）、吸氣峰壓（PIP）、氣道平臺壓（Pplat）及氣道阻力（Raw）等呼吸力學(xué)指標均顯著降低（P<0.05），且觀察組顯著低于對照組（P<0.05）。治療后兩組血氧飽和度（SaO₂）、二氧化碳分壓（pCO₂）、血氧分壓（pO₂）及氧合指數(shù)（pCO₂/FiO₂）血氣指標均顯著改善（P<0.05），且觀察組變化顯著優(yōu)于對照組（P<0.05）。治療后兩組白細胞介素-6（IL-6）、白細胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）、C反應(yīng)蛋白（CRP）等炎性細胞因子水平均明顯降低（P<0.05），且觀察組顯著低于對照組（P<0.05）。結(jié)論 血必凈注射液聯(lián)合鹽酸氨溴索可有效改善老年重癥患者的呼吸力學(xué)指標及血氣指標，抑制炎性反應(yīng)，提高療效，具有較高的應(yīng)用價值。

Objective To investigate the effect of Xuebijing Injection combined with Ambroxol hydrochloride on respiratory mechanics, gas and blood indexes and cytokine levels in elderly patients with severe pneumonia.Methods 80 elderly patients with severe pneumonia in our hospital were selected from July 2016 to July 2019. According to the random dynamic principle, the subjects were divided into 40 cases in the control group and 40 cases in the study group. Patients in the control group received Ambroxol hydrochloride, the patients in the study group were treated with Xuebijing Injection combined with ambroxol hydrochloride. The changes of total effective rate, respiratory mechanics before and after treatment, gas and blood indexes and cytokines were compared between the two groups.Results The proportion of the total effective in the study group was significantly higher than that in the control group (P<0.05). Compared with before treatment, the respiratory mechanics and blood gas indexes of the two groups were significantly improved after treatment, and the study group was significantly better than the control group (P<0.05). Compared with before treatment, the respiratory mechanics and blood gas indexes of the two groups were significantly improved after treatment, and the research group was significantly better than the control group (P<0.05). Compared with before treatment, the levels of inflammatory cytokines in both groups were significantly reduced after treatment, and the study group was significantly lower than the control group (P<0.05).Conclusion Xuebijing Injection combined with Ambroxol hydrochloride can effectively improve the respiratory mechanics index and blood gas index of elderly patients with severe disease, inhibit inflammatory reaction, improve curative effect, and has high application value.

陜西省自然基金項目（2016JM8080）