METHODS: A total of 156 COPD patients complicated with pulmonary infections were included. Their blood gas, airway resistance, health status, expression levels of TLR-2 and TLR-4, and pulmonary function were analyzed after treatment with β-lactam antibiotics.
RESULTS: Blood gas indices oxygen saturation, partial pressure of oxygen, and partial pressure of carbon dioxide at one day before treatment, on the fifteenth day of treatment, and on the first day after the end of treatment showed significant differences (p < 0.01). Significant differences were also detected in airway resistance indices (p < 0.01). The differences in the mRNA expression levels of TLR-2 and TLR-4 were significant (p < 0.05). Downward trends were observed in the clinical pulmonary infection score and acute physiology and chronic health evaluation II score, which indicated alleviation of the disease. Pulmonary function indices recorded vital capacity (VC)/predicted VC (%), recorded forced vital capacity at 1 s (FEV1)/predicted FEV1 (%), and residual volume/total lung capacity were significantly different (p < 0.05).
CONCLUSIONS: β-Lactam antibiotics had obvious therapeutic effects on COPD patients complicated with pulmonary infections, probably by suppressing or attenuating TLR-2- and TLR-4-mediated inflammatory responses. It is necessary to comprehensively evaluate and choose appropriate antibiotics, aiming for maximum relief of the pain to help patients recover quickly.
方法:纳入156例COPD合并肺部感染患者。他们的血气,气道阻力,健康状况,分析β-内酰胺类抗生素治疗后TLR-2和TLR-4的表达水平和肺功能。
结果:血气指标氧饱和度,氧分压,和治疗前一天的二氧化碳分压,在治疗的第十五天,且在治疗结束后第1天表现出显著差异(p<0.01)。气道阻力指数也有显著差异(p<0.01)。TLR-2和TLR-4的mRNA表达水平差异有统计学意义(p<0.05)。观察到临床肺部感染评分和急性生理和慢性健康评估II评分的下降趋势,这表明疾病的缓解。肺功能指数记录肺活量(VC)/预测VC(%),1s时记录的强迫肺活量(FEV1)/预测的FEV1(%),和残余容积/总肺活量有显著差异(p<0.05)。
结论:β-内酰胺类抗生素对COPD合并肺部感染患者有明显的治疗作用。可能通过抑制或减弱TLR-2和TLR-4介导的炎症反应。要综合评价,选择合适的抗生素,旨在最大程度地缓解疼痛,帮助患者快速康复。