盐酸氨溴索诱导痰与传统诱导痰法在老年社区获得性肺炎临床应用的比较

目的比较盐酸氨溴索导痰与传统法导痰在老年社区获得性肺炎中的临床应用。方法将120例60岁以上老年社区获得性肺炎患者入院时随机分成两组。A组用3％盐水2ml＋盐酸氨溴索15mg，B组用3％高渗盐水4ml，分别进行压缩雾化导痰，两组患者痰液送检并进行痰培养。结果A组不良反应发生率为3．3％，B组为30．0％；A组排痰成功率为98．3％，合格率88．3％，B组排痰成功率为75．0％，合格率71．7％。以上差异均有统计学意义（P〈0．05）。A，B两组导痰的痰量分别为（9．5±2．0）ml和（7．5±2．3）ml；细胞数分别为（9．5±1．3）×10^9L和（10．2±1．3）×10^9L；肿瘤坏死因子α（TNF-α）水平分别为（74±9）ng／L和（61＋8）ng／L；白介素-8（IL-8）水平分别为（96±8）ng／L和（84±56）ng／L；痰培养阳性率分别为70．0％和50．0％。A，B两组在痰量、细胞数、TNF-α和IL-8、痰培养阳性率方面的差异均有统计学意义（P〈0．05）。结论在老年社区获得性肺炎患者中盐酸氨溴索导痰较传统导痰法更加安全有效。

Comparison of clinical applications of ambroxol hydrochloride and tradi- tional sputum inductions in senior patients with community-acquired pneumonia

Objective To compare the clinical applications of ambroxol hydrochloride and traditional sputum induction in senior patients with community-acquired pneumonia. Methods A total of 120 senior patients with community-acquired pneumonia were randomly divided into two groups at admission. Patients in group A received 2 ml of 3% saline plus 15 mg ambroxol hydrochloride, and 4 ml 3% hypertonic saline in group B. Both were administered through compressed-air nebulized inhalation. Sputum samples from all subjects were tested and cultured. Results The adverse effect incidences in groups A and B were 3.3% and 30.0%, respectively. The success rate of sputum excretion was 98.3% and qualification rate was 88.3% in group A, vs 75.0% and 71.7% in group B, respectively. There were significant differences between groups A and B （P〈0.05）. The sputum volume was （9.5±2.0） ml in group A vs （7.5±2.3） ml, the cell counts were （9.5±1.3）×10^9L vs （10.2±1.3）×10^9L, the TNF-α levels were （74±9） ng/L vs （61±8） ng/L, the IL-8 levels were （96±8） ng/L vs （84±56） ng/L, and the positive culture rates were 70.0% vs 50.0% in groups A and B, respectively. There were significant differences between groups A and B （P〈0.05）. Conclusion For senior patients with community-acquired pneumonia, the sputum induction with ambroxol hydrochloride is safer and more effective than the traditional one.