目的探讨不同剂量氨溴索对老年慢性阻塞性肺疾病（COPD）患者的疗效及肺功能的影响。方法选取200例COPD患者,随机分为两组,大剂量组（102例）给予大剂量（60 mg/次）盐酸氨溴索静脉滴注,小剂量组（98例）给予小剂量（30 mg/次）盐酸氨溴索静脉滴注,通过比较治疗后的疗效、肿瘤坏死因子-α（TNF-α）、血清超敏C反应蛋白（CRP）、肺功能指标及治疗期间不良反应情况,评价不同剂量氨溴索对老年慢性阻塞性肺疾病患者的疗效及肺功能的影响。结果大剂量组有效率89.2%,小剂量组有效率75.5%,大剂量组的治疗有效率高于小剂量组（P<0.05）。治疗前,两组CRP和TNF-α相比无统计学差异；治疗后两组CRP和TNF-α水平均明显降低（P<0.05）,且大剂量组CRP和TNF-α水平明显低于对照组（P<0.05）。治疗前,两组FVC、FEV1和FEV1/FVC%相比,差异无统计学意义；治疗后两组FVC、FEV1和FEV1/FVC%均明显升高（P<0.05）,且大剂量组上述肺功能指标明显高于小剂量组（P<0.05）。治疗期间,两组不良反应率无明显差异。结论大剂量氨溴索对慢性阻塞性肺疾病用药安全有效,可显著减小肺部炎症反应,提高肺部通气量,值得临床推广使用。

Objective To investigate the effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease. Methods 200 patients with COPD were selected. They were divided into two groups randomly. The high dose group (102 cases) were given anmbroxol hydrochloride in high doses. The low dose group (98 cases) were given anmbroxol hydrochloride in low doses. The effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease was evaluated by the efficacy, TNF-α, CRP, pulmonary function indexes and adverse reaction during treatment. Results The effective rate was 89.2% in the high dose group and 75.5% in the low dose group. The effective rate of high dose group was higher than that of the low dose group (P < 0.05). Before treatment, there were no statistical significance on CRP and TNF-α between two groups. After treatment, the CRP and TNF-α were decreased in two groups and lower in the high dose group (P < 0.05). Before treatment, there were no statistical significance on FVC, FEV1 and FEV1/FVC% between two groups. After treatment, FVC, FEV1 and FEV1/FVC were increased and higher in the high dose group (P < 0.05). During treatment, there were no statistical significance on adverse reaction between two groups. Conclusion High dose of ambroxol was effective and safe for COPD. It could reduce inflammation and improve pulmonary ventilation with clinical use.