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目的探讨内皮素受体拮抗剂对喘息型慢性支气管炎急性发作期呼吸道阻力的影响,为喘息型慢性支气管炎急性发作期的治疗提供依据。方法喘息型慢性支气管炎急性发作期患者90例,随机分为联合治疗组和常规治疗组,每组45例,常规治疗组给予适量吸氧、抗炎、止咳化痰、解痉平喘,必要时吸痰等常规治疗,联合治疗组在常规治疗的基础上加服阿魏酸钠片,观察治疗前后患者临床主要症状、肺功能指标、血浆内皮素水平的变化。结果与常规治疗组[分别为194.01%±65.33%、63.33%±5.20%、(224.65±17.57)L/min、(61.49±18.60)pg/ml]比较,联合治疗组患者呼吸道阻力(109.67%±48.26%)明显降低,肺功能指标第1秒用力呼气容积(FEV1)(79.54%±5.82%)、呼气流速峰值(PEF)([253.14±16.93)L/min]均明显升高,血浆内皮素水平([39.72±16.38)pg/ml]明显降低,差异均有统计学意义(P<0.05),临床疗效也优于常规治疗组。结论应用内皮素受体拮抗剂阿魏酸钠治疗喘息型支气管炎急性发作期可降低患者呼吸道阻力,改善患者临床主要症状,增强肺功能,提高临床疗效。
Objective To investigate the effect of endothelin receptor antagonist on respiratory resistance in asthmatic patients with acute exacerbation of chronic bronchitis and provide basis for the treatment of acute exacerbation of chronic bronchitis. Methods 90 patients with acute exacerbation of wheeze type chronic bronchitis were randomly divided into combined treatment group and conventional treatment group, 45 cases in each group. The conventional treatment group was given appropriate amount of oxygen, anti-inflammatory, cough and phlegm, antispasmodic and antiasthmatic, Sputum and other conventional treatment. The combined treatment group added sodium ferulate on the basis of routine treatment, and observed the clinical main symptoms, pulmonary function indexes and plasma endothelin levels before and after treatment. Results Compared with the conventional treatment group [(194.01% ± 65.33%, 63.33% ± 5.20%, (224.65 ± 17.57) L / min, (61.49 ± 18.60) pg / ml] 48.26%) were significantly decreased. FEV1 (79.54% ± 5.82%) and peak expiratory flow (PEF) ([253.14 ± 16.93] L / min] The level of endothelin ([39.72 ± 16.38] pg / ml] was significantly lower than that of the conventional treatment group (P <0.05). Conclusions The application of sodium ferulate, an endothelin receptor antagonist, in the treatment of asthmatic bronchitis during acute exacerbation may reduce the respiratory resistance, improve the clinical symptoms, enhance the lung function and improve the clinical efficacy.