肺纤维化合并慢阻肺急性加重期患者应用头孢唑肟与倍氯米松序贯治疗的临床研究
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江苏省南通市卫生健康委员会科研项目(QA2021052);


Clinical efficacy of cefazoxime and beclomethasone sequential therapy in patients with pulmonary fibrosis complicated by acute exacerbation of chronic obstructive pulmonary disease
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    摘要:

    目的:评估头孢唑肟与倍氯米松序贯治疗方案对肺纤维化(PF)合并慢性阻塞性肺疾病(COPD)急性加重期患者的临床价值。方法:选取120例PF合并COPD急性加重期患者为研究对象,按照治疗方式不同将患者分为常规组(接受左氧氟沙星静脉抗感染治疗联合全身性糖皮质激素治疗)和研究组(在常规治疗基础上增加头孢唑肟与倍氯米松序贯治疗),每组各60例,比较两组患者临床疗效、氧合状态、炎症因子水平、生活质量及近远期预后。结果:研究组患者临床总有效率98.33%,高于常规组的85.00%(P<0.05)。治疗后,两组患者动脉血氧分压(PaO2)与氧合指数(PaO2/FiO2)水平均升高,且研究组高于常规组(P<0.05);PaCO2均降低,且研究组低于常规组(P<0.05)。治疗后,两组患者炎症因子水平、COPD评估测试(CAT)评分和改良呼吸困难量表(mMRC)评分均降低,且研究组低于常规组(P<0.05)。两组患者不良反应总发生率及近期复发率无统计学差异(P>0.05);研究组患者远期复发率为6.67%,显著低于常规组的21.67%(P<0.05)。结论:头孢唑肟联合倍氯米松序贯治疗可显著提升PF-COPD急性加重期患者的综合疗效,能有效控制感染与炎症、优化症状与生活质量,有较高应用价值。

    Abstract:

    Objective:To assess the clinical value of cefazoxime and beclomethasone sequential therapy in patients with pulmo-nary fibrosis(PF)complicated by acute exacerbations of chronic obstructive pulmonary disease(COPD).Methods:A total of 120 pa-tients with acute exacerbation of PF and COPD were divided into the conventional group(the patient received intravenous levofloxacin for anti-infection treatment in combination with systemic glucocorticoid therapy)and the study group(cefazoxime and beclomethasone sequential treatment on the basis of conventional treatment)according to different treatment methods,60 cases in each group.The clini-cal efficacy,oxygenation status,inflammatory factor levels,quality of life,short-term and long-term prognosis were compared between the two groups.Results:The total clinical efficacy of the study group was 98.33%,which was higher than 85.00%of the conventional group(P<0.05).After treatment,the improvements in arterial partial pressure of oxygen(PaO2),and oxygenation index(PaO2/FiO2)increased in both groups,and the study group was higher than the conventional group(P<0.05).Partial pressure of carbon di-oxide(PaCO2)decreased in both groups,and the study group was lower than the conventional group(P<0.05).After treatment,the levels of inflammatory factors,COPD assessment test(CAT)score and modified dyspnea scale(mMRC)score in both groups de-creased,and the study group was lower than the conventional group(P<0.05).There was no statistically significant difference in the overall incidence of adverse reactions and recent recurrence rate between the study group and the conventional group(P>0.05).The long-term recurrence rate in the study group was 6.67%,which was lower than that of the conventional group(21.67%)(P<0.05).Conclusion:Cefazoxime combined with beclomethasone sequential therapy can significantly improve the comprehensive efficacy of pa-tients with acute exacerbation of PF-COPD,which can effectively control infection and inflammation,optimize symptoms and quality of life,and has high application value.

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印希;钱佳燕;冒昕欣;缪雨青;史广林;.肺纤维化合并慢阻肺急性加重期患者应用头孢唑肟与倍氯米松序贯治疗的临床研究[J].川北医学院学报,2025,40(8):1025-1029.

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  • 在线发布日期: 2025-08-10
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