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糖皮质激素治疗AECOPD疗效及其对患者凝血功能的影响

  • 蔡毅峰,陈科署,李杨,蔡文阳

* 通信作者: 蔡毅峰, 单位:潮州市中心医院重症医学科呼吸内科

摘要

【摘要】
目的:探究在慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease ,AECOPD)的治疗中应用糖皮质激素的效果及对患者凝血功能的影响。

方法:选取本院2015年1月~2016年12月收治的80例AECOPD患者,随机分对照组和观察组。对照组给予氧疗、支气管扩张剂,必要时应用抗菌素等常规性治疗,观察组在对照组的基础上给予口服泼尼松(40mg/d),疗程5天。比较两组患者的临床疗效以及治疗前后血气分析、肺功能相关指标、凝血功能指标和炎症因子水平。

结果:对照组和观察组的治疗总有效率分别为80.00%和97.50%,观察组明显高于对照组(χ2=4.507,P=0.034);两组患者不良反应发生情况无统计学差异(7.50%和12.50%,χ2=0.139,P=0.709)。与对照组治疗后相比,观察组治疗后的FEV1、FEV1/FVC和FEV1占预计值明显升高,差异间均有统计学意义(P<0.05)。与对照组治疗后相比,观察组治疗后PaO2明显升高、PaCO2值显著降低(P<0.05)。两组患者治疗后APTT、PT、TT水平均显著升高,且观察组患者APTT、PT的水平均显著高于对照组患者治疗后水平(P<0.05);同时,两组患者治疗后FIB、D-二聚体、CRP的水平均明显降低,且观察组患者均显著低于对照组患者治疗后水平(P<0.05)。

结论:在AECOPD患者中应用糖皮质激素具有较好的临床疗效,有助于患者肺功能和凝血功能的改善。

关键词:【关键词】糖皮质激素;AECOPD;凝血功能;炎症因子

ABSTRACT

【Abstract】
Objective: To investigate the effect of glucocorticoid on the coagulation function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: 80 cases of patients with AECOPD in our hospital from January 2015 to September 2016 were chosen as the subjects. The selected patients were randomly divided into two groups, namely the control group and the observation group. The patients in the control group were received routine treatment, the observation group were given conventional treatment and treated with glucocorticoid for 5 d. The clinical efficacy, blood gas analysis, lung function related index, coagulation function index and inflammatory factor level of the two groups before and after treatment were compared.

Results: The total effective rates were 80.00% and 97.50% in the control and observation groups, respectively, and the observation group was significantly higher than the control group (χ2 = 4.507, P = 0.034). There was no significant difference between the two groups (7.50% 12.50%, χ2 = 0.139, P = 0.709). FEV1 / FVC and FEV1 were significantly higher than those in the control group (P <0.05), and the difference was statistically significant (P <0.05). Compared with the control group, PaO2 was significantly increased and PaCO2 was significantly decreased in the observation group (P <0.05). APTT, PT and TT were significantly increased in the two groups after treatment, and the levels of APTT and PT in the observation group were significantly higher than those in the control group (P <0.05). At the same time, the levels of FIB, D-dimer, CRP levels were significantly lower, and the observation group were significantly lower than the control group of patients after treatment level (P <0.05).

Conclusion  : In patients with AECOPD, glucocorticoids have better clinical efficacy, and can improve pulmonary function and coagulation function obviously.

Key words: 【Keywords】Glucocorticoids; AECOPD; coagulation function; inflammatory factors

引用本文 / How to Cite This Article

蔡毅峰,陈科署,李杨,蔡文阳.糖皮质激素治疗AECOPD疗效及其对患者凝血功能的影响[J]. 国际精神病学杂志, , (): -

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