目的 探讨血必净注射液联合盐酸氨溴索对老年重症肺炎患者呼吸力学、血气指标及细胞因子水平的影响。方法 选取2016年7月—2019年7月榆林市星元医院80例老年重症肺炎患者，根据随机动态原则将受试者分为对照组40例和观察组40例，对照组接受盐酸氨溴索治疗，观察组接受血必净注射液联合盐酸氨溴索治疗，比较两组的治疗总有效率、治疗前后呼吸力学、血气指标及细胞因子等指标变化。结果 观察组治疗的总有效率为95.00%，显著高于对照组的77.50%（P<0.05）。治疗后两组的平均气道压（mPaw）、吸气峰压（PIP）、气道平台压（Pplat）及气道阻力（Raw）等呼吸力学指标均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。治疗后两组血氧饱和度（SaO₂）、二氧化碳分压（pCO₂）、血氧分压（pO₂）及氧合指数（pCO₂/FiO₂）血气指标均显著改善（P<0.05），且观察组变化显著优于对照组（P<0.05）。治疗后两组白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）等炎性细胞因子水平均明显降低（P<0.05），且观察组显著低于对照组（P<0.05）。结论 血必净注射液联合盐酸氨溴索可有效改善老年重症患者的呼吸力学指标及血气指标，抑制炎性反应，提高疗效，具有较高的应用价值。

Objective To investigate the effect of Xuebijing Injection combined with Ambroxol hydrochloride on respiratory mechanics, gas and blood indexes and cytokine levels in elderly patients with severe pneumonia.Methods 80 elderly patients with severe pneumonia in our hospital were selected from July 2016 to July 2019. According to the random dynamic principle, the subjects were divided into 40 cases in the control group and 40 cases in the study group. Patients in the control group received Ambroxol hydrochloride, the patients in the study group were treated with Xuebijing Injection combined with ambroxol hydrochloride. The changes of total effective rate, respiratory mechanics before and after treatment, gas and blood indexes and cytokines were compared between the two groups.Results The proportion of the total effective in the study group was significantly higher than that in the control group (P<0.05). Compared with before treatment, the respiratory mechanics and blood gas indexes of the two groups were significantly improved after treatment, and the study group was significantly better than the control group (P<0.05). Compared with before treatment, the respiratory mechanics and blood gas indexes of the two groups were significantly improved after treatment, and the research group was significantly better than the control group (P<0.05). Compared with before treatment, the levels of inflammatory cytokines in both groups were significantly reduced after treatment, and the study group was significantly lower than the control group (P<0.05).Conclusion Xuebijing Injection combined with Ambroxol hydrochloride can effectively improve the respiratory mechanics index and blood gas index of elderly patients with severe disease, inhibit inflammatory reaction, improve curative effect, and has high application value.

陕西省自然基金项目（2016JM8080）