目的 觀察注射用丹參多酚酸鹽對(duì)慢性阻塞性肺疾病患者急性加重期的臨床療效。方法 選取上海市嘉定區(qū)南翔醫(yī)院2014年4月—2015年4月收治的慢性阻塞性肺病患者76例,隨機(jī)分為對(duì)照組和治療組,每組各38例。對(duì)照組患者給予常規(guī)治療,治療組患者在對(duì)照組治療基礎(chǔ)上加用注射用丹參多酚酸鹽200 mg,溶于5%葡萄糖注射液250 mL中,靜脈滴注,1次/d。兩組患者均連續(xù)治療14 d。評(píng)價(jià)兩組患者治療后的臨床療效,并比較兩組治療前后的各血清炎性因子水平和平均肺動(dòng)脈壓。結(jié)果 治療后,治療組患者的總有效率為81.6%,顯著高于對(duì)照組的70.1%,兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組血清白介素-18(IL-18)、C反應(yīng)蛋白(CRP)水平均較治療前顯著降低,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);與對(duì)照組比較,治療組血清IL-18、CRP水平降低程度均顯著優(yōu)于對(duì)照組(P<0.05)。治療后兩組肺動(dòng)脈壓水平均顯著下降,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組治療后的下降程度明顯高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 注射用丹參多酚酸鹽治療COPD急性加重期具有很好的臨床療效,可降低血清炎癥因子IL-18和CRP水平以及平均肺動(dòng)脈壓,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Depsides Salts from Salvia miltiorrhiza in Lyophilizied Powder for injection on the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Patients (76 cases) with acute exacerbation of COPD in Shanghai Jiading Nanxiang Hospital from April 2014 to April 2015 were randomly divided into control and treatment groups, and each group had 38 cases. The patients in the control group were given conventional treatment. The patients in the treatment group were iv administered with Depsides Salts from Salvia miltiorrhiza in Lyophilizied Powder for injection on the basis of the control group, 200 mg Depsides Salts from Salvia miltiorrhiza in Lyophilizied Powder for injection added into 5% Glucose Injection 250 mL, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical effects of two groups were evaluated. The levels of inflammatory factors and pulmonary arterial pressure of two groups before and after the treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 70.1% and 81.6%, respectively, and there were differences between two groups (P < 0.05). After treatment, levels of IL-18 and CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, pulmonary arterial pressures in two groups were obviously decreased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Depsides Salts from Salvia miltiorrhiza in Lyophilizied Powder for injection has clinical curative effect in treatment of acute exacerbation of COPD, can decrease the levels of inflammatory factors IL-18 and CRP in serum and the average pulmonary arterial pressure, which has a certain clinical application value.