CAJ | 학술논문

目的观察长期小剂量服用罗红霉素对支气管扩张症稳定期患者胸部CT影像学及临床症状改变的影响.方法 50例支气管扩张症患者按随机数字表法分为对照组和治疗组,对照组25例,男14例,女11例,口服盐酸氨溴索30 mg/次,3次/d；治疗组25例,男12例,女13例,口服盐酸氨溴索30 mg/次,3次/d及罗红霉素0.15g/次,1次/d,两组疗程均为6个月.所有患者在治疗前和治疗后均进行圣·乔治评分和英国医学研究委员会的呼吸困难量表评分,评价呼吸困难及胸部CT影像学的改变.结果治疗6个月后,对照组生活质量评分(48±13)比治疗前(58±15)降低,但对照组扩张支气管壁厚度积分(1.8±0.5)比治疗前(1.8±0.4)高.治疗组的胸部CT影像学评分中扩张支气管及周围病变占肺叶面积积分(2.7±1.6)、扩张支气管壁厚度积分(1.3±0.4)和胸部CT影像学总积分(6.7±2.5)分别比治疗前的[(4.8±2.3)、(1.8±0.5)及(9.5±3.3)]降低.治疗组治疗后的呼吸困难评分(1.3±0.4)及生活质量评分(42±12)均比治疗前[(1.9±0.5)和(56±15)]降低.治疗组治疗后胸部CT影像学评分中扩张支气管及周围病变占肺叶面积积分(2.7±1.6)、扩张支气管壁厚度积分(1.3±0.4)和胸部CT影像学总积分(6.7±2.5)比治疗前[(4.8±2.0)、(1.8±0.5)及(9.7±3.6)]显著降低.治疗后治疗组呼吸困难评分(1.3±0.4)比对照组(1.7±0.4)显著改善.结论缓解期支气管扩张症患者的支气管壁厚度积分仍在增加.长期口服小剂量罗红霉素联合盐酸氨溴索可改善稳定期支气管扩张症患者支气管扩张及其周围病变占肺叶面积、扩张支气管管壁增厚积分及胸部CT影像学总评分及呼吸困难评分.
목적 관찰장기소제량복용라홍매소대지기관확장증은정기환자흉부CT영상학급림상증상개변적영향.방법 50례지기관확장증환자안수궤수자표법분위대조조화치료조,대조조25례,남14례,녀11례,구복염산안추색30 mg/차,3차/d；치료조25례,남12례,녀13례,구복염산안추색30 mg/차,3차/d급라홍매소0.15g/차,1차/d,량조료정균위6개월.소유환자재치료전화치료후균진행골·교치평분화영국의학연구위원회적호흡곤난량표평분,평개호흡곤난급흉부CT영상학적개변.결과 치료6개월후,대조조생활질량평분(48±13)비치료전(58±15)강저,단대조조확장지기관벽후도적분(1.8±0.5)비치료전(1.8±0.4)고.치료조적흉부CT영상학평분중확장지기관급주위병변점폐협면적적분(2.7±1.6)、확장지기관벽후도적분(1.3±0.4)화흉부CT영상학총적분(6.7±2.5)분별비치료전적[(4.8±2.3)、(1.8±0.5)급(9.5±3.3)]강저.치료조치료후적호흡곤난평분(1.3±0.4)급생활질량평분(42±12)균비치료전[(1.9±0.5)화(56±15)]강저.치료조치료후흉부CT영상학평분중확장지기관급주위병변점폐협면적적분(2.7±1.6)、확장지기관벽후도적분(1.3±0.4)화흉부CT영상학총적분(6.7±2.5)비치료전[(4.8±2.0)、(1.8±0.5)급(9.7±3.6)]현저강저.치료후치료조호흡곤난평분(1.3±0.4)비대조조(1.7±0.4)현저개선.결론 완해기지기관확장증환자적지기관벽후도적분잉재증가.장기구복소제량라홍매소연합염산안추색가개선은정기지기관확장증환자지기관확장급기주위병변점폐협면적、확장지기관관벽증후적분급흉부CT영상학총평분급호흡곤난평분.
Objective To investigate the impact of treatment with low dose roxithromycin on clinical symptoms and CT scores in patients with stable bronchiectasis.Methods Fifty patients with bronchiectasis in stable condition were randomly assigned toa control group and a treatment group.Patients in the control group received ambroxol hydrochloride tablet 90 mg 3 times a day.Patients in the treatment group received roxithromycin disperse tablet 0.15 g every day and ambroxol hydrochloride tablet 90 mg 3 times a day.The course of treatment lasted for 6 months.Quality of life was assessed using St.George's respiratory questionnaire (SGRQ).The British Medical Research Council (MRC) dyspnea scale was used to assess the degree of dyspnea.The score for CT evaluation of the thorax,quality of life and SGRQ were performed for all patients before and after the treatment.Results After 6 months,the scores for quality of life (48 ± 13)were lower compared to that (58 ± 15) before treatment in the control group; however,the scores for bronchial wall thickening of bronchiectasis (1.8 ± 0.5) were higher than that (1.8 ± 0.4) before study.The scores for the extent of bronchiectasis (2.7 ± 1.6),the bronchial wall thickening of bronchiectasis (1.3 ± 0.4) and the global CT score (6.7 ± 2.5)were reduced after treatment as compared to those before treatment [(4.8±2.3),(1.8±0.5),(9.5±3.3)] in the treatment group,(allP＜0.01).The degree of dyspnea(1.3 ±0.4)and quality of life(42 ± 12)were lower than those before treatment [(1.89 ±0.45),(56 ± 15)] in the treatment group.Furthermore,the scores for extent of bronchiectasis(2.7 ± 1.6),the scores for the bronchial wall thickening of bronchiectasis (1.3 ± 0.4) and the global CT score (6.7 ± 2.5) in the treatment group were significantly improved as compared with those [(4.8 ± 2.0),(1.8 ± 0.5),(9.7 ±3.6)] in the control group respectively after treatment.At the same time,the degree of dyspnea(1.3 ±0.4)in the treatment group was significantly improved as compared with that (1.7 ± 0.4)in the control group after treatment.Conclusions The scores for the bronchial wall thickening of bronchiectasis were increased in patients with stable bronchiectasis.Low dose roxithromycin combined with ambroxol hydrochloride significantly improved degree of dyspnea,reduced scores for extent of bronchiectasis,scores for the bronchial wall thickening of bronchiectasis and the global CT score as compared to treatment with ambroxol hydrochloride alone in patients with bronchiectasis in stable condition.