文章摘要

多索茶碱联合盐酸氨溴索治疗老年稳定期COPD的临床疗效及对血清IL-33/sST2轴表达的影响

作者: 1潘萍
1 无锡市锡山人民医院/东南大学附属中大医院无锡分院全科医学科，江苏 无锡214000
通讯: 潘萍 Email: panpingwuxi@163.com
DOI: 10.3978/j.issn.2095-6959.2022.09.007

摘要

目的：探讨多索茶碱联合盐酸氨溴索治疗老年稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)的临床疗效及对血清IL-33/sST2轴表达的影响。方法：选择2020年1月至2022年1月无锡市锡山人民医院门诊收治的110例老年稳定期COPD患者，随机分为对照组与试验组，每组55例。对照组给予单纯多索茶碱治疗，试验组给予多索茶碱联合盐酸氨溴索治疗。比较两组的临床疗效、治疗前后肺功能、外周血IL-33、sST2的mRNA和蛋白表达水平、血清炎症因子水平及不良反应发生率。结果：试验组治疗总有效率为94.55%(52/55)，高于对照组的74.55%(41/55；P<0.05)。试验组治疗14 d后第1秒用力呼气容积(forced expiratory volume in 1 second，FEV1)、用力肺活量(forced vital capacity，FVC)、FEV1)/FVC及呼气峰值流速(peak expiratory flow，PEF)水平分别为(1.97±0.28) L、(3.50±0.37) L、0.74±0.10、(3.53±0.52) L/s，均高于对照组(均P<0.05)。试验组治疗14 d后IL-33、sST2的mRNA表达水平分别为1.20±0.24、1.10±0.19，IL-33、sST2的蛋白水平分别为(382.07±35.40) pg/mL、(567.37±54.51) pg/mL，均低于对照组(均P<0.05)。试验组治疗14 d后外周血IL-6、IL-8、CRP、TNF-α水平分别为(5.94±0.98) ng/L、(251.06±12.28) ng/L、(4.71±0.92) mg/L、(11.98±2.12) pg/L，均低于对照组(均P<0.05)。试验组治疗总不良反应发生率为7.27%(4/55)，低于对照组的21.82%(12/55；P<0.05)。结论：多索茶碱联合盐酸氨溴索治疗老年稳定期COPD患者疗效确切，可改善肺功能，抑制血清IL-33/sST2轴表达水平，降低炎症因子水平，且不良反应小，安全可靠。
关键词： 多索茶碱；盐酸氨溴索；老年；慢性阻塞性肺疾病；疗效；IL-33/sST2轴表达；肺功能；不良反应

Clinical efficacy of doxofylline combined with ambroxol hydrochloride in the treatment of elderly patients with stable COPD and its effect on the expression of serum IL-33/sST2 axis

Authors: 1PAN Ping
1 Department of General Medicine, Xishan People’s Hospital of Wuxi/Wuxi Branch of Zhongda Hospital Affiliated to Southeast University, Wuxi Jiangsu 214000, China

CorrespondingAuthor: PAN Ping Email: panpingwuxi@163.com

DOI: 10.3978/j.issn.2095-6959.2022.09.007

Abstract

Objective: To investigate the clinical efficacy of doxofylline combined with ambroxol hydrochloride in the treatment of elderly patients with stable chronic obstructive pulmonary disease (COPD) and its effect on the expression of serum IL-33/sST2 axis. Methods: A total of 110 elderly patients with stable COPD who were admitted to the outpatient clinic of Xishan People’s Hospital of Wuxi from January 2020 to January 2022 were selected and randomly divided into the control group and the experimental group, with 55 cases in each group. The control group was given doxofylline alone, and the experimental group was given doxofylline combined with ambroxol hydrochloride. The clinical efficacy, lung function, IL-33, sST2 mRNA and protein expression levels, serum inflammatory factor levels and incidence of adverse reactions were compared between the 2 groups before and after the treatment. Results: The total effective rate in the experimental group was 94.55% (52/55), which was higher than 74.55% (41/55) in the control group (P<0.05). After 14 days of treatment, the levels of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, and peak expiratory flow (PEF) in the experimental group were (1.97±0.28) L, (3.50±0.37) L, 0.74±0.10, (3.53±0.52) L/s, which were higher than those in the control group (all P<0.05). After 14 days of treatment in the experimental group, the mRNA expression levels of IL-33 and sST2 were (1.20±0.24) and (1.10±0.19), respectively, and the protein levels of IL-33 and sST2 were (382.07±35.40) pg/mL, (567.37±0.19) pg/mL, all lower than the control group (all P<0.05). The levels of IL-6, IL-8, CRP and TNF-α in the experimental group after 14 days of treatment were (5.94±0.98) ng/L, (251.06±12.28) ng/L, (4.71±0.92) mg/L, (11.98±2.12) pg/L, all lower than the control group (all P<0.05). The total adverse reaction rate in the experimental group was 7.27% (4/55), which was lower than 21.82% (12/55) in the control group (P<0.05). Conclusion: Doxofylline combined with ambroxol hydrochloride is effective in the treatment of elderly patients with stable COPD, can improve lung function, inhibit the expression level of serum IL-33/sST2 axis, reduce the level of inflammatory factors, and has few adverse reactions, which is safe and reliable.

Keywords： doxofylline; ambroxol hydrochloride; elderly; chronic obstructive pulmonary disease; efficacy; IL-33/sST2 axis expression; pulmonary function; adverse reactions

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