己酮可可碱吸入治疗对慢性阻塞性肺疾病患者血凝状态和内皮功能的影响

目的 探索己酮可可碱（pentoxifylline,PTX)吸入治疗对慢性阻塞性肺疾病（COPD）血凝状态和内皮功能的影响。方法 60例COPD患者，随 机单盲分成两组：（1）治疗组31例：PTX100mg加生理盐水5ml雾化吸入；（2）对照组29例：糜蛋白酶5mg加生理盐水5ml雾化吸入。两组均每日2次， 疗程2周。治疗前后常规检查肺功能（FEV1）、动脉血气、肝肾功能、血凝指标、血浆及全血粘滞度和内皮素－1（ET－1）等。所有患者停用氮茶碱制剂72h以上。结果 治疗组治疗后PCV、D－二聚体、血浆及全血粘度（高切和低切）均明显下降（P＜0．01）；随血凝状态的改善内皮功能也得到改善，ET－1下降。PaO2及SaO2％增高（P＜0．01）；血肌酐降低（P＜0．05）；对照组各指标均无变化（P＞0．05）。两组治疗前后肝功能及尿素氮无统计学差异（P＞0．05）。结论 本实验表明，PTX吸入治疗对改善COPD高凝状态和内皮功能具有较好的疗效。

The effects of Pentoxifylline on the blood coagulable status and endotheliocyte function in patients with chronic ob structive pulmonary disease

Objective To study the effects of inhaled Pentoxifylline(PTX) on the blood coagulable status and endotheliocyte function in patients with chronic obstructive pneumalry disease(COPD). Methods 60 cases were randomly divided into two groups by single blind. Treatment group: 31 cases, PTX 100mg in 5 ml normal saline. Control group: 29 cases, chymotrypsin 5 mg in 5 ml normal saline. All cases were inhaled by ultrasonic nebulization, b.i.d. for 2 wk. Before and after treatment, pulmonary function (FEV 1), arterial blood gas analysis, blood coagulability and ET 1 were examined in all cases. Aminophylline was discontinued for 72hs before treatment. Results After treatment, PCV, D D, blood viscosity and coagulable parameters and ET 1 were significantly decreased( P <0.01.) With the improvement of the above parameters, PaO 2 and SaO 2% increased ( P <0.01). There are no significant changes in the control group. Conclusion Pentoxifylline inhalation has good effects on hypercogulable status and endotheliocyte function in patients with chronic obstructive pulmonary disease.