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目的探讨低剂量罗红霉素和脾氨肽联合治疗支气管扩张症稳定期的临床效果。方法选取2013年3月-2016年1月于本院诊治的支气管扩张症稳定期患者90例进行研究,随机原则分为研究组(45例)和对照组(45例),对照组给予祛痰平喘等常规治疗,治疗组在常规治疗基础上加用罗红霉素及脾氨肽口服冻干粉,连续应用6个月。比较2组患者外周血INF-γ和IL-4的水平及CD4~+及CD8~+细胞改变情况、呼吸困难评分、生活质量评分、病情急性发作次数、咳痰量、胸部CT影像学评分情况。结果治疗后,研究组患者INF-γ/IL-4及CD4~+/CD8~+较对照组好转;胸部CT总评分、扩张支气管的厚度评分、病变肺叶面积评分、病变组织占肺叶面积评分均较治疗前、对照组明显下降;2组患者治疗后的呼吸困难评分、生活质量评分、病情急性发作次数、咳痰量均较治疗前降低,差异均有统计学意义(P<0.05)。结论对临床中支气管扩张症稳定期患者实施低剂量罗红霉素和脾氨肽联合治疗,效果显著,值得推广。
Objective To investigate the clinical effect of low-dose roxithromycin and spleen ammonia peptide in the treatment of stable bronchiectasis. Methods From March 2013 to January 2016, 90 patients with stable bronchiectasis in our hospital were selected and randomly divided into study group (45 cases) and control group (45 cases). The control group was given expectorant Asthma and other conventional treatment, the treatment group on the basis of routine treatment plus roxithromycin and spleen ammonia peptide oral freeze-dried powder, continuous application of 6 months. The levels of INF-γand IL-4 in the peripheral blood and the changes of CD4 ~ + and CD8 ~ + cells, dyspnea score, quality of life score, the number of acute exacerbations, sputum volume and CT score of chest CT were compared between the two groups . Results After treatment, the levels of INF-γ / IL-4 and CD4 ~ + / CD8 + in the study group were better than those in the control group. The total chest CT score, bronchodilator thickness score, lesion lung area score, lesion area and lung area score Compared with before treatment, the control group was significantly decreased; dyspnea scores, quality of life scores, the number of acute attacks and the amount of sputum sputum after treatment in both groups were significantly lower than those before treatment (P <0.05). Conclusion The combination of low-dose roxithromycin and splenectomy in patients with stable bronchiectasis in clinical stage has a significant effect and is worthy of promotion.