目的 探討乙酰半胱氨酸泡騰片聯(lián)合鹽酸氨溴索注射液治療老年慢性阻塞性肺病急性發(fā)作期的臨床療效。方法 選取2015年9月—2016年12月上海市浦東新區(qū)南碼頭社區(qū)衛(wèi)生服務(wù)中心收治的老年慢性阻塞性肺疾病患者84例為研究對象，所有患者按照隨機數(shù)字表法分為對照組和治療組，每組各42例。對照組靜脈滴注鹽酸氨溴索注射液，60 mg加入到5%葡萄糖注射液100 mL中，1次/d。治療組在對照組基礎(chǔ)上溫水沖服乙酰半胱氨酸泡騰片，600 mg/次，2次/d。兩組患者均連續(xù)治療2周。觀察兩組的臨床療效，比較兩組的血氣指標、肺功能和血清細胞因子水平。結(jié)果 治療后，對照組和治療組的總有效率分別為76.19%、92.86%，兩組比較差異有統(tǒng)計學意義（P < 0.05）。治療后，兩組血氧分壓（PaO₂）、1秒用力呼氣容積（FEV₁）和FEV₁/用力肺活量（FVC）水平均顯著升高，而動脈血二氧化碳分壓（PaCO₂）水平顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P < 0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P < 0.05）。治療后，兩組C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）和γ-干擾素（IFN-γ）水平均顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P < 0.05）；且治療組這些觀察指標的下降程度明顯優(yōu)于對照組，兩組比較差異有統(tǒng)計學意義（P < 0.05）。結(jié)論 乙酰半胱氨酸泡騰片聯(lián)合鹽酸氨溴索注射液治療老年慢性阻塞性肺病急性發(fā)作期具有較好的臨床療效，能改善肺功能，減輕炎癥反應(yīng)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate clinical effect of Acetylcysteine Effervescent Tablets combined with Ambroxol Hydrochloride Injection in treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease. Methods Patients (84 cases) with cerebral infarction in Shanghai Pudong New Area South Pier Community Health Service Center from September 2015 to December 2016 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were iv administered with Ambroxol Hydrochloride Injection, 60 mg added into 5% glucose solution 100 mL, once daily. Patients in the treatment group were po administered with Acetylcysteine Effervescent Tablets on the basis of the control group, 600 mg/time, twice daily. Patients in two groups were treated for two weeks. After treatment, the clinical efficacies were evaluated, and blood gas indexes, pulmonary function, and serum cytokines in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.19% and 92.86%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of PaO₂, FEV1, and FEV1/FVC in two groups were significantly increased, but the levels of PaCO₂ in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of CRP, TNF-α, and IFN-γ in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Acetylcysteine Effervescent Tablets combined with Ambroxol Hydrochloride Injection has clinical curative effect in treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease, can improve pulmonary function, and reduce inflammatory reaction, which has a certain clinical application value.