Observation Of Curative Effect And Serum Concentration Monitoring Of Theophylline In AECOPD Patients

Objective In this study,two drugs of aminophylline and Doxofylline used in acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients,monitoring the serum theophylline concentrations and lung function in two groups.attempt to explore the difference of effective blood concentration rang,pulmonary function changes,therapeutic effect and adverse reactions between two types of treatment that given by intravenous add oral.in order to provide a basis for clinical rational medication.Methodes Selected 78 cases of patients with AECOPD are associated with gasping symptoms,in patients with medication before the symptoms of the quantitative assessment and determination of pulmonary function,and then randomized comparison of methods, patients were randomly divided into treatment group Aminophylline and treatment group Doxofylline.Aminophylline treatment group 40 cases,oral theophylline sustained-release tablets 100mg,bid;combined with Aminophylline 250mg in 5%glucose 250ml intravenous injection,qd.Doxofylline treatment group 38 patients,oral tablets doxofylline 200mg,bid; combined with doxofylline injection 200mg in 5%glucose 250ml intravenous injection,qd.In the treatment of 1 week,2 weeks later;Determination of fasting blood aminophylline (polarization fluoroimmunoassay) and Doxofylline(High Performance Liquid Chromatography) steady-state plasma trough concentrations and lung function parameters in patients with repeated measurements.Treatment two weeks after the end of the trial, assessment on quantitative once again,to determine efficacy,also calculated the incidence of adverse reactions.Results 1.One week after,administration of aminophylline group steady-state trough concentrations' average value for 8.54±1.55μg/ml;administration after two weeks of steady-state concentration' average value for 9.96±2.13μg/ml.Group administration Doxofylline,the steady-state concentration' average value one week later,for 2.71±1.38μg/ml:administration Valley after two weeks of steady-state concentration' average value for 3.92±1.66μg/ml.2.After variance analysis,two sets of lung function in patients with FEV1,FEV1%, FEV1/FVC,FVC,PEF after treatment,comparison with pre-treatment,F values were 167.083,7187.934,1899.507,779.348,1267.664,P values were＜0.001,the difference was statistically significant,compared in two treatment groups of FEV1,FEV1%,FEV1/FVC, FVC,PEF improvement,F values were0.505,0.019,0.041,0.944,0.796,P values were 0.480,0.892,0.840,0.334,0.052(P＞0.05),There was no statistically significant difference.3.Two weeks later after treatment,aminophylline group on gasping,cough,sputum volume,the sound of wheezing were 62.5%,55.0%,15.0%,82.5%efficiency; Doxofylline group of gasping,cough,sputum volume,the sound of wheezing were 57.9%,65.8%,10.5%,78.9%efficiency.After chi-square test,the datas comparison between the two groups breathing,cough,sputum volume,efficient wheezing sound,χ~2 values were 0.173,0.795,0.349,0.060;P values were 0.427,0.260,0.402,0.493(P＞0.05),the difference was not statistically significance.4.The incidence of adverse reactions Doxofylline group(27.3%) lower than the aminophylline group(52.4%);comparison between the two groups,After chi-square test,χ~2 = 4.804,P = 0.025,the difference was statistically significant.Conclusions Steady-state serum concentration of aminophylline in the Valley 5.2 13.2μg/ml scope,Doxofylline steady-state serum trough concentrations in the range of 0.5～7.98μg/ml has improved with recent pulmonary function FEV1,FEV1%,FEV1/FVC(%),FVC, PEF for AECOPD patients associated with gasp.About the improvement of lung function, aminophylline similar to Doxofylline,both of them should not be neglected in the treatment of AECOPD.both treatment programs for gasp,cough,sputum,wheezing have similar therapeutic effect.The adverse events caused by two types treatments of the observed group, the incidence of adverse events in doxofylline group lower than the aminophylline group. Doxofylline better security,recommended for those patients who can not be tolerated the adverse events of aminophylline and elderly patients.