中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2008年
7期
521-524
,共4页
肺疾病,慢性阻塞性%祛痰药%白细胞介素-8%肿瘤坏死因子-α
肺疾病,慢性阻塞性%祛痰藥%白細胞介素-8%腫瘤壞死因子-α
폐질병,만성조새성%거담약%백세포개소-8%종류배사인자-α
Pulmonary disease,chronic obstructive%Expectorants%Interleukin-8%Tumor necrosis factor-alpha
目的 观察老年慢性阻塞性肺疾病(COPD)患者盐酸氨溴索诱导痰的安全性及有效性和急性加重期及稳定期老年COPD患者盐酸氨溴索诱导痰中细胞组分和可溶性介质水平变化,探讨其在气道炎症研究中的作用.方法 老年COPD急性加重期患者40例分为两组,每组20例,分别雾化吸入4 ml高渗盐水(3%)(高渗盐水组)及2 ml高渗盐水(3%)+盐酸氨溴索2 ml(15 mg)(盐酸氨溴索组)诱导排痰,对比两组患者不良反应发生率、排痰成功率、痰液中细胞组分、炎症介质.测定盐酸氨溴索组COPD患者急性加重期、稳定期诱导痰中细胞总数、单核细胞百分比、中性粒细胞百分比、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)浓度及其第1秒用力呼气容积(FEV1)、FEV1占预计值%.结果 两组不良反应发生率、排痰成功率分别为55.0%、25.0%和75.0%、100.0%,差异有统计学意义(P＜0.05).两种方法诱导痰的细胞成分及炎症介质比较,差异无统计学意义(P＞0.05).盐酸氨溴索组患者急性加重期诱导痰液中细胞总数、单核细胞百分比、中性粒细胞百分比、IL-8及TNF-α浓度分别为(3.45±0.52)×108/L、38.8%±4.3%、30.8%±3.1%、(316.75±43.14)ng/L及(39.40±4.58)ng/L;稳定期分别为(2.94±0.57)X108/L、29.1%±6.1%、28.2%±4.2%、(170.00±25.70)ng/L及(20.60±5.10)ng/L;急性加重期与稳定期比较,差异有统计学意义(P＜0.05);盐酸氨溴索组患者痰液中细胞总数、单核细胞及中性粒细胞百分比、IL-8及TNF-α浓度和FEV1占预计值%呈负相关(急性加重期及稳定期r值分别为-0.728、-0.793、-0.816、-0.794、-0.605及-0.635、-0.746、-0.721、-0.658、-0.654).结论 盐酸氨溴索诱导痰是一种安全、有效的研究方法,在阐明老年COPD患者气道炎症的发生、发展及病情检测中有意义.
目的 觀察老年慢性阻塞性肺疾病(COPD)患者鹽痠氨溴索誘導痰的安全性及有效性和急性加重期及穩定期老年COPD患者鹽痠氨溴索誘導痰中細胞組分和可溶性介質水平變化,探討其在氣道炎癥研究中的作用.方法 老年COPD急性加重期患者40例分為兩組,每組20例,分彆霧化吸入4 ml高滲鹽水(3%)(高滲鹽水組)及2 ml高滲鹽水(3%)+鹽痠氨溴索2 ml(15 mg)(鹽痠氨溴索組)誘導排痰,對比兩組患者不良反應髮生率、排痰成功率、痰液中細胞組分、炎癥介質.測定鹽痠氨溴索組COPD患者急性加重期、穩定期誘導痰中細胞總數、單覈細胞百分比、中性粒細胞百分比、白細胞介素-8(IL-8)及腫瘤壞死因子-α(TNF-α)濃度及其第1秒用力呼氣容積(FEV1)、FEV1佔預計值%.結果 兩組不良反應髮生率、排痰成功率分彆為55.0%、25.0%和75.0%、100.0%,差異有統計學意義(P＜0.05).兩種方法誘導痰的細胞成分及炎癥介質比較,差異無統計學意義(P＞0.05).鹽痠氨溴索組患者急性加重期誘導痰液中細胞總數、單覈細胞百分比、中性粒細胞百分比、IL-8及TNF-α濃度分彆為(3.45±0.52)×108/L、38.8%±4.3%、30.8%±3.1%、(316.75±43.14)ng/L及(39.40±4.58)ng/L;穩定期分彆為(2.94±0.57)X108/L、29.1%±6.1%、28.2%±4.2%、(170.00±25.70)ng/L及(20.60±5.10)ng/L;急性加重期與穩定期比較,差異有統計學意義(P＜0.05);鹽痠氨溴索組患者痰液中細胞總數、單覈細胞及中性粒細胞百分比、IL-8及TNF-α濃度和FEV1佔預計值%呈負相關(急性加重期及穩定期r值分彆為-0.728、-0.793、-0.816、-0.794、-0.605及-0.635、-0.746、-0.721、-0.658、-0.654).結論 鹽痠氨溴索誘導痰是一種安全、有效的研究方法,在闡明老年COPD患者氣道炎癥的髮生、髮展及病情檢測中有意義.
목적 관찰노년만성조새성폐질병(COPD)환자염산안추색유도담적안전성급유효성화급성가중기급은정기노년COPD환자염산안추색유도담중세포조분화가용성개질수평변화,탐토기재기도염증연구중적작용.방법 노년COPD급성가중기환자40례분위량조,매조20례,분별무화흡입4 ml고삼염수(3%)(고삼염수조)급2 ml고삼염수(3%)+염산안추색2 ml(15 mg)(염산안추색조)유도배담,대비량조환자불량반응발생솔、배담성공솔、담액중세포조분、염증개질.측정염산안추색조COPD환자급성가중기、은정기유도담중세포총수、단핵세포백분비、중성립세포백분비、백세포개소-8(IL-8)급종류배사인자-α(TNF-α)농도급기제1초용력호기용적(FEV1)、FEV1점예계치%.결과 량조불량반응발생솔、배담성공솔분별위55.0%、25.0%화75.0%、100.0%,차이유통계학의의(P＜0.05).량충방법유도담적세포성분급염증개질비교,차이무통계학의의(P＞0.05).염산안추색조환자급성가중기유도담액중세포총수、단핵세포백분비、중성립세포백분비、IL-8급TNF-α농도분별위(3.45±0.52)×108/L、38.8%±4.3%、30.8%±3.1%、(316.75±43.14)ng/L급(39.40±4.58)ng/L;은정기분별위(2.94±0.57)X108/L、29.1%±6.1%、28.2%±4.2%、(170.00±25.70)ng/L급(20.60±5.10)ng/L;급성가중기여은정기비교,차이유통계학의의(P＜0.05);염산안추색조환자담액중세포총수、단핵세포급중성립세포백분비、IL-8급TNF-α농도화FEV1점예계치%정부상관(급성가중기급은정기r치분별위-0.728、-0.793、-0.816、-0.794、-0.605급-0.635、-0.746、-0.721、-0.658、-0.654).결론 염산안추색유도담시일충안전、유효적연구방법,재천명노년COPD환자기도염증적발생、발전급병정검측중유의의.
Objective 1.To establish an improved method by inhaling hyperosmotic saline and mucosolvan ampoule and to observe the security and validity in elderly patients with chronic obstructive pulmonary disease(COPD).2.To observe the changes of cell component and soluble substance in the induced sputum of the elderly patients with COPD at their acute and stable stage,and explore the role of these substances in airway inflammation. Methods 1.40 elderly patients with COPD who were at their acute stage were stochastically divided into two groups,20 patients each,who inhaled hyperosmotic saline(3%)(group A)and hyperosmotie saline(3%)plus ambroxol hydrochloride(group B).We compared their electrocardiogram before and after inhalation,lung function,saturation of oxygen in artery,cell component,inflammatory factors in sputum and validity of inducing sputum.2.The cell component,inflammatory factors and the lung function of the patients in group B were determined at their acute and stable stage. Results 1.55.0% of the patients in group A felt uncomfortable.and 2 of them had excessive bronchial irritability so not undergoing sputum inducement.However,side effects were found in only 5 patients of the group B.Side effects in the group B were lower than those in hyperosmotic saline group(P＜0.05).Before and after the experiment,electrocardiogram of the patients in the two groups had no statistical difference(P＞0.05).It was the same as lung function and oxygenic saturation.Cell component and inflammatory faetors in the sputum of the two groups had no statistical difference(P＞0.05).2.In group B,the total cells,monoeyte,neutrophil,IL-8 and TNF-αof the patients at their acute stage were(3.4 5±0.52)×108/L,(38.8±4.3)%,(30.8±3.1)%,(316.75±43.14)ng/L,(39.4±4.58)ng/L.respectively.And those at their stable stage were(2.94±0.57)×108/L,(29.1±6.1)%,(28.2±4.2)%,(170.00±25.70)ng/L,(20.60±5.10)ng/L,respectively.The total cells,monocyte,neutrophils,IL-8 and TNF-α in acute and stable stage of the patients had statistical significance(P＜0.05).There was a negative correlation of the total cells,monocyte,neutrophil,IL-8,TNF-αwith the degree of the disease in group B at acute and stable stage. Conclusions The results suggest that inhaling ambroxol hydrodiloride is a practical,safe and effective method,for clarifying the mechanism of airway inflammation in elderly patients with COPD.
