目的 探讨厄多司坦分散片联合硫酸沙丁胺醇吸入气雾剂治疗慢性阻塞性肺疾病（COPD）的疗效及对血清因子的影响。方法 选择2018年5月—2020年5月在南阳南石医院治疗的126例COPD患者，根据用药的差别分为对照组（63例）和治疗组（63例）。对照组吸入硫酸沙丁胺醇吸入气雾剂，2揿/次，2次/d；治疗组在对照组的基础上口服厄多司坦分散片，0.3 g/次，2次/d。两组患者经2周治疗。观察两组患者临床疗效，比较治疗前后两组患者动脉血气指标、肺功能、APACHE Ⅱ评分、mMRC评分、CPIS评分、Murray肺损伤评分，及血清降钙素原（PCT）、血管性血友病因子（vWF）、白细胞介素-18（IL-18）、高迁移率族蛋白B1（HMGB1）、单核细胞趋化蛋白1（MCP-1）和肿瘤坏死因子-α（TNF-α）水平。结果 经治疗，对照组有效率为82.54%，显著低于治疗组的96.83%（P<0.05）。经治疗，两组pO₂和SaO₂显著升高（P<0.05），而pCO₂显著降低（P<0.05），且治疗组改善最明显（P<0.05）。经治疗，两组50%最大呼气流速（PEF50）、第1秒末用力呼气量（FEV1）、最大呼气压（PEMAX）、最大口腔吸气压（PIMAX）均明显升高，且治疗组明显高于对照组（P<0.05）。经治疗，两组APACHE Ⅱ评分、mMRC评分、CPIS评分、Murray肺损伤评分均显著降低，且治疗组降低更明显（P<0.05）。经治疗，两组血清PCT、vWF、IL-18、HMGB1、MCP-1、TNF-α水平均明显下降（P<0.05），且治疗组明显低于对照组（P<0.05）。结论 厄多司坦分散片联合硫酸沙丁胺醇吸入气雾剂治疗COPD可有效改善肺功能和动脉血气指标，降低机体炎症反应，降低APACHE Ⅱ评分、mMRC评分、CPIS评分、Murray肺损伤评分。

Objective To investigate the efficacy of Erdostine Dispersible Tablets combined with salbutamol sulfate in treatment of chronic obstructive pulmonary disease and its effect on serum factors. Methods Patients (126 cases) with chronic obstructive pulmonary disease in Nanyang Nanshi Hospital from May 2018 to May 2020 were divided into control (63 cases) and treatment (63 cases) groups based on different treatments. Patients in the control group were administered with Salbutamol Sulfate Inhalation Aerosol, 2 press/time, twice daily. Patients in the treatment group were po administered with Erdostine Dispersible Tablets on the basis of the control group, 0.3 g/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the arterial blood gas indexes, pulmonary function, APACHE Ⅱ scores, mMRC scores, CPIS scores, Murray scores, and the serum levels of PCT, vWF, IL-18, HMGB1, MCP-1, and TNF-α in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 82.54%, which was significantly lower than that of 96.83% in the treatment group (P<0.05). After treatment, pO₂ and SaO₂ increased significantly (P<0.05), while pCO₂ decreased significantly in both groups (P<0.05), and the improvement was the most obvious in the treatment group (P<0.05). After treatment, PEF50, FEV1, PEMAX and PIMAX in both groups were significantly increased (P<0.05), and those in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, APACHE Ⅱ score, mMRC score, CPIS score and Murray lung injury score in both groups were significantly decreased (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of PCT, vWF, IL-18, HMGB1, MCP-1 and TNF-α in the two groups were significantly decreased (P<0.05), and which in the treatment group was significantly lower than those in the control group (P<0.05). Conclusion Erdostatin Dispersible Tablets combined with Salbutamol Sulfate Inhalation Aerosol in the treatment of chronic obstructive pulmonary disease can effectively improve pulmonary function and arterial blood gas index, reduce inflammatory response, reduce APACHE Ⅱ score, mMRC score, CPIS score and Murray lung injury score.

R974

河南省医学科技攻关计划项目（201403258）