目的 探究福多司坦联合复方异丙托溴铵治疗慢性阻塞性肺疾病急性加重期（AECOPD）的治疗效果。方法 选取2023年6月—2024年12月于南阳市中心医院确诊并接受规范治疗的90例AECOPD患者为研究对象，采用随机数字表法分为对照组（45例）和治疗组（45例）。对照组患者给予吸入用复方异丙托溴铵溶液雾化，2.5 mL/次，每次取2.5 mL加入2.5 mL生理盐水稀释后使用，每日3次。治疗组在对照组治疗基础上口服福多司坦片，单次剂量为0.4 g，每日3次，均为餐后服用。两组AECOPD患者均接受为期7 d的连续治疗。观察两组的临床疗效和症状缓解时间，比较两组治疗前后慢性阻塞性肺疾病评估测试（CAT）评分、慢性阻塞性肺疾病晨间症状量表（COPD-MSD）评分，血清CC趋化因子受体7（CCR7），分泌型磷脂酶A2-X（sPLA2-X）和血管紧张素转化酶2（ACE2）水平变化。结果 治疗结果显示，治疗组总有效率是93.33%，显著高于对照组的75.56%（P＜0.05）。治疗组咳嗽、咳痰及呼吸困难的缓解时间均较对照组显著缩短（P＜0.05）。两组患者CAT评分和COPD-MSD评分均显著降低（P＜0.05）；而治疗后，治疗组患者CAT评分和COPD-MSD评分均显著低于对照组（P＜0.05）。治疗后，治疗组血清CCR7、sPLA2-X显著降低，而ACE2水平显著升高（P＜0.05）；治疗后，治疗组血清CCR7、sPLA2-X低于对照组，而ACE2水平高于对照组（P＜0.05）。结论 福多司坦联合复方异丙托溴铵治疗AECOPD疗效显著，不但可显著缩短患者临床症状的缓解时间并改善其生活质量，而且能促进血清学指标的修复，具有临床推广价值。

Objective To investigate the clinical efficacy of fudosteine combined with compound ipratropium bromide in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 90 AECOPD patients diagnosed and receiving standard treatment in Nanyang Central Hospital from June 2023 to December 2024 were selected as the study objects, and were divided into control group (45 cases) and treatment group (45 cases) by random number table method. Patients in control group were given atomization of Compound Ipratropium Bromide Solution for inhalation, 2.5 mL/time, each time 2.5 mL was taken and diluted with 2.5 mL normal saline, 3 times daily. Patients in treatment group were po administered with Fudosteine Tablets after meals on basis of the control group, a single dosage of 0.4 g, 3 times daily. Both groups of AECOPD patients received continuous treatment for 7 d. Clinical efficacy and symptom remission time of the two groups were observed, changes of CAT scores, COPD-MSD scores, serum CCR7, sPLA2-X, and ACE2 before and after treatment were compared between two groups. Results The results showed that the total effective rate of treatment group was 93.33%, which was significantly higher than that of control group (75.56%, P < 0.05). The remission time of cough, sputum and dyspnea in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, CAT scores and COPD-MSD scores in treatment group were significantly decreased (P < 0.05). After treatment, CAT scores and COPD-MSD scores in treatment group were significantly lower than those in the control group (P < 0.05). After treatment, serum CCR7 and sPLA2-X in treatment group were significantly decreased, but the level of ACE2 was significantly increased (P < 0.05). After treatment, the serum CCR7 and sPLA2-X levels in treatment group were lower than those in control group, but the serum ACE2 levels were higher than those in control group (P < 0.05). Conclusion Fodosteine combined with compound ipratropium bromide is effective in the treatment of AECOPD, not only can significantly shorten the remission time of clinical symptoms and improve the quality of life of patients, but also can promote the repair of serological indicators, which has clinical promotion value.

R974

河南省医学科技攻关计划联合共建项目（LHGJ20230970）