乌司他丁联合异丙托漠镀治疗AECOPD的疗效及对血清炎症因子、血管内皮功能、肺功能的影响摘要目的观察乌司他丁联合异丙托澳镀治疗慢性阻塞性肺疾病急性加重期（AECOPD）的疗效及对血清炎症因子、血管内皮功能、肺功能的影响。方法将125例AECOPD病例依据随机分为观察组（64例）和对照组（61例）。对照组在常规治疗的基础上给予异丙托澳績,观察组在对照组的基础上给予乌司他丁。治疗1周，观察两组疗效及血清炎症因子（hs-CRP、TNF-a、IL-l、IL-8）、血管内皮功能相关指标（ET-l、NO、TXB2、VEGF）、肺功能（TLC、PEF、PEF25、PEF5O）的差异。结果①疗效比较观察组显效率48.43%,有效率35.31%,无效率6.25；对照组显效率29.51%,有效率60.66%,无效率9.84%。两组疗效比较差异有统计学意义（Z=-2.123F0.034）；②血清炎症因子水平比较两组hs-CRP、TNF-a.IL-kIL-8均明显下降（方观察组二23.173、19.294、8.382、16.291,作0.000、0.000、0.000、0.000；t对照组=19.385、16.732、6.713、13.185,7^0.000>0.000、0.000、0.000）,且观察组降幅大于对照组，同期比较差异有统计学意义（匸5.419、5.184、4.893、7.241,余0.000、0.002、0.006、0.000）；③血管内皮功能相关指标水平比较两组NO、VEGF上升而ET-］、TXB?下降（Z观察沪14.728、17.482、12.103>17.827,洋0.000、0.000、0.000、0.000；£对爾二11.745、12.483、6.386、12.097,00.000、0.000、0.000、0.000）,且观察组变化幅度大于对照组,同期比较差异有统计学意义（片9.182、18.831、6.271、11.382,P0.000、0.000、0.000、0.000）；④肺功能比较两组TLC、FEVi、PEF25及PEF50均上升（如飙=10.742、8.736、9.014>11.422,£0.000、0.000、0.000、0.000；方对照姐=7.618、6.801、7.194、8.275,住0.000、0.000、0.000、0.000）,且观察组变化幅度大于对照组，同期比较差异有统计学意义（A5.402、4.927、4.238、5.701,作0.009、0.011、0.019、0.003）。结论乌司他丁联合异丙托澳钱治疗AECOPD的疗效确切，能更有效的抑制炎症反应、保护血管内皮功能及肺功能。关键词慢性阻塞性肺疾病；异丙托漠镀；乌司他丁；炎症因子；血管内皮功能；肺功能中图分类号：R563.9文献标识码：A文章编号：EfficacyandEffectonSeruminflammatoryFactors,VascularEndothelialFunctionandPulmonaryFunctionofUlinastatinCombinedwithIpratropiumBromideintheTreatmentofAECOPDAbstractObjectiveToobservetheefficacyandeffectonseruminflammatoryfactors,vascularendothelialfunctionandpulmonaryfunctionofulinastatincombinedwithipratropiumbromideinthetreatmentofAECOPD.Methods125casesofpatientswithAECOPDwererandomlydividedintoobservationgroup(64cases)andcontrolgroup(61cases).Thecontrolgroupweregivenipratropiumbromidebasedonconventionaltherapy,andtheobservationgroupweregivenulinastatinbasedonthecontrolgroup.After1week,toobservetheclinicalefficacyanddifferencesofseruminflammatoryfactors(hs-CRP,TNF-a,IL-1,IL-8),vascularendothelialfunctionrelatedindicators(ET-1,NO,TXB?,VEGF),andpulmonaryfunction(TLC,PEFbPEF25,PEF50)betweenthetwogroup・Results(DComparisonofcurativeefficacyTheobservationgroupofexcelleneerate48.43%,effectivewasrate35.31%5inefficiencywas6.25%,andthoseofthecontrolgroupwas29.51%,60.66%,9.84%.Theclinicalefficacyofthetwogroupsshowedsignificantdifference(Z=-2.123P=0・034);②ComparisonofseruminflammatoryfactorsThetwogroupsofhs-CRP.TNF-a,IL-6,IL-8weredecreasedwithbefore(/observationgroup=23.173,19.294,8.382,16.291P=0.000,0.000,0.000,0.000；zcontrO|group=19.385,16.732,6.713,13.185P=0.00050.000,0.000,0.000),andallindexsoftheobservationgroupimprovedmoresignificantlythanthatofthecontrolgroup,withstatisticaldifference(Z=5.419,5.184,4.893,7.241P=0.000,0.002,0.006,0.000);③ComparisonofvascularendothelialfunctionThetwogroupsofNO,VEGFweredecreasedandET-l,TXB2,...