注射用甲泼尼龙琥珀酸钠联合多索茶碱对AECOPD患者炎症指标和肺功能的影响

Effects of Methylprednisolone Sodium Succinate for Injection Combined with Doxofylline on Inflammatory Markers and Pulmonary Function in Patients with AECOPD

摘要

目的 探讨注射用甲泼尼龙琥珀酸钠联合多索茶碱对慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者炎症指标和肺功能的影响。方法 回顾性纳入2023年1月至2024年1月张家港市第一人民医院收治的300例AECOPD患者，根据不同治疗方案分为对照组和观察组，各150例。2组均予以AECOPD标准基础治疗，对照组加用多索茶碱治疗，观察组在对照组治疗基础上联合应用甲泼尼龙琥珀酸钠。比较2组治疗前后血气分析指标、免疫球蛋白、血清炎症指标及肺功能等的变化。结果 治疗1周及2周后，观察组的血气分析指标、免疫球蛋白和血清炎症指标优于对照组（P < 0.05）；治疗2周后，观察组的肺功能指标优于对照组（P < 0.05）。治疗2周后，观察组的慢性阻塞性肺疾病评估测试（Chronic Obstructive Pulmonary Disease Assessment Test，CAT）评分低于对照组（P < 0.05）。2组不良反应发生率差异无统计学意义（P > 0.05）。结论 注射用甲泼尼龙琥珀酸钠与多索茶碱联用治疗AECOPD能明显提高临床效果，改善血气参数、调节免疫及抑制炎症，且有效促进肺功能恢复。

Abstract

Objective To investigate the effects of methylprednisolone sodium succinate for injection combined with doxofylline on inflammatory markers and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods This retrospective study included 300 patients with AECOPD admitted to Zhangjiagang First People's Hospital from January 2023 to January 2024. All patients were divided into a control group and an observation group, with 150 cases in each group. Both groups received standard basic treatment for AECOPD. On the basis of the standard basic treatment, the control group was additionally given doxofylline, and the observation group was further combined with methylprednisolone sodium succinate for injection. Blood gas parameters, immunoglobulins, serum inflammatory markers, and pulmonary function were compared between the two groups before and after treatment. Results After 1 and 2 weeks of treatment, the blood gas parameters, immunoglobulins, and serum inflammatory markers in the observation group were significantly improved compared with those in the control group (P < 0.05). After 2 weeks of treatment, the pulmonary function indicators of the observation group were better than those of the control group (P < 0.05). After 2 weeks of treatment, the COPD Assessment Test (CAT) score in the observation group was lower than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion The combination of methylprednisolone sodium succinate for injection and doxofylline significantly improves clinical outcomes in AECOPD patients by optimizing blood gas parameters, modulating immune responses, and suppressing systemic inflammation, thereby enhancing pulmonary function recovery.

关键词

注射用甲泼尼龙琥珀酸钠 / 多索茶碱 / 慢性阻塞性肺疾病急性加重期 / 炎症指标 / 肺功能

Key words

methylprednisolone sodium succinate for injection / doxofylline / acute exacerbation of chronic obstructive pulmonary disease / inflammatory markers / pulmonary function

参考文献

[1] 鄞晓斌, 邱名耀, 吴海琴, 等. 血清α1—AT和NE水平变化与AECOPD患者病情程度关系及预测呼吸衰竭的价值[J].临床急诊杂志, 2022, 23(6):390-394.

[2] 杨锐锋, 黄雨欣, 綦向军, 等. 苏黄止咳胶囊辅助治疗慢性阻塞性肺疾病急性加重期的系统评价[J].中国医院用药评价与分析, 2022, 22(12):1496-1501.

[3] 章昱, 张晨雨. 甲强龙结合多索茶碱方案对AECOPD患者肺通气功能及血清炎性因子表达的影响[J].生命科学仪器, 2023, 21(5):79-82.

[4] 王晓娟, 方向阳. 慢性阻塞性肺疾病全球倡议2019: 慢性阻塞性肺疾病诊断、治疗与预防全球策略解读[J].中国全科医学, 2019, 22(18):2141-2149.

[5] 杨传亮, 张谷香, 刘汉辰. 多索茶碱辅助无创呼吸机治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭的疗效观察[J].中国医刊, 2024, 59(7):737-740.

[6] Meduri G U, Shih M C, Bridges L,et al. Low—dose methylprednisolone treatment in critically ill patients with severe community—acquired pneumonia[J].Intensive Care Med, 2022, 48(8):1009-1023.

[7] 国家卫生健康委员会急诊医学质控中心, 中华医学会急诊医学分会, 中国医师协会急诊医师分会, 等. 中国慢性阻塞性肺疾病急性加重中西医诊治专家共识(2021)[J].中华危重病急救医学, 2021, 33(11):1281-1290.

[8] Liu M S, Li Y N, Yin D F,et al. COPD assessment test as a screening tool for anxiety and depression in stable COPD patients: a feasibility study[J].COPD J Chronic Obstr Pulm Dis, 2023, 20(1):144-152.

[9] Chen Z Y, Lin Y M, Wu J H,et al. Effect of doxofylline on pulmonary inflammatory response and oxidative stress during mechanical ventilation in rats with COPD[J].BMC Pulm Med, 2022, 22(1):66.

[10] 张继娟, 邓贤坤. 活血祛痰方对COPD急性加重期患者HCY、CPR、血气分析及认知功能的影响[J].贵州医药, 2025, 49(10):1581-1583.

[11] 杨万荣, 任治坤, 时新颍. 沙丁胺醇雾化吸入脾多肽治疗AECOPD的疗效分析[J/OL].中华肺部疾病杂志(电子版), 2024, 17(4):609-612.

[12] Palikhe N S, Niven M, Fuhr D,et al. Low immunoglobulin levels affect the course of COPD in hospitalized patients[J].Allergy Asthma Clin Immunol, 2023, 19(1):10.

[13] 马泽嵋, 文月月, 徐湛翔, 等. 慢性阻塞性肺疾病急性加重期合并支气管扩张患者P选择素与降钙素原、凝血功能的相关性研究[J].中国医刊, 2024, 59(11):1197-1200.

[14] Dimic—Janjic S, Hoda M A, Milenkovic B,et al. The usefulness of MMP—9, TIMP—1 and MMP—9/TIMP—1 ratio for diagnosis and assessment of COPD severity[J].Eur J Med Res, 2023, 28(1):127.

[15] Qin J, Huang G, Lin X,et al. Efficacy of methylprednisolone sodium succinate combined with acoustic resonance therapy on inflammatory response indicators and cerebral microcirculation in patients with sudden sensorineural hearing loss[J].Eur J Med Res, 2025, 30(1):547.

[16] Saiphoklang N, Panichaporn S, Siriyothipun T,et al. Effects of oral doxofylline and procaterol on chronic obstructive pulmonary disease: a randomized crossover study[J].Med Sci (Basel), 2025, 13(2):49.

[17] 陈绍霞, 王颖, 赵泰宇. 慢性阻塞性肺疾病患者吸气峰流速影响因素的研究进展[J].中国呼吸与危重监护杂志, 2025, 24(5):361-364.

[18] 于营, 卢冬喜, 赵婧. NE、IFN—γ、α1—AT水平及Treg/Th17对AECOPD患者并发呼吸衰竭的预测价值[J].分子诊断与治疗杂志, 2025, 17(2):383-386.