Efficacy Evaluation And Safety Analysis Of Doxofylline In Patients With Acute Exacerbation Of COPD

ObjectiveChronic obstructive pulmonary disease?COPD?is a common disease that seriously endangers human health.Acute exacerbation of 0.5-3.5 times a year is the leading cause of death in patients with chronic obstructive pulmonary disease?COPD?.Theophylline drugs induce airway dilatation by inhibiting phosphodiesterase-induced specific phosphorylation,which can be used in patients with chronic obstructive lung.Because theophylline drug therapy window is narrow and theophylline drugs have obvious side effects,it is not recommended to treat aecopd patients with chronic obstructive pulmonary disease at present,and it is difficult to detect theophylline concentration in primary medical institutions in China.The purpose of this study was to investigate the therapeutic effects and adverse reactions of Chinese patients with aecopd due to gene and species differences,in order to provide reference value for clinical use of theophylline drugs.MethodsFrom September 2017 to August 2018,50 patients with acute exacerbation of COPD were admitted to the third affiliated Hospital of Anhui Medical University,including 35males and 15 females.According to the method of random number table,25 cases were divided into observation group and control group.There were 19 males and 6 females in the observation group,16 males and 9 females in the control group.The patients in the control group were given routine treatment such as oxygen inhalation,anti-infection,spasmolysis,anti-inflammatory and glucocorticoid therapy.The observation group was treated with doxophylline 0.3g intravenous drip qd on the basis of the control group,and the clinical symptoms of the two groups were improved.The cat score,blood gas analysis and other indexes were compared between the two groups.The fasting serum concentration of doxofylline in the observation group was measured on day 4,and the adverse drug reactions of doxofylline were recorded.Results1 The mean age of AECOPD patients was 76.96±8.034 years old in the observation group and 75.56±6.965 years in the control group,and there was no significant difference between the two groups?P>0.05?.The average aggravation time was 5.36±2.767 days in the observation group and 5.40±3.136 days in the control group,and there was no significant difference between the two groups?P>0.05?.The number of previous hospitalizations in the observation group was 3.00±1.500 and that in the control group was 2.92±1.412 days,and there was no significant difference between the two groups?P>0.05?.There was no significant difference in pulmonary function grade,complications?hypertension,diabetes and coronary heart disease?between the observation group and the control group?P>0.05?.2 In blood gas analysis,the mean value of pH before and after treatment was 7.367±0.05121 and 7.378±0.02167 in the observation group and 7.3731±0.04362 and 7.3794±0.02081 in the control group before and after treatment respectively.The mean PaO₂before and after treatment was 63.968±8.3598mmHg and 95.781±16.7292mmHg respectively in the observation group and 64.663±8.4358mmHg and 82.906±8.4519mmHg before and after treatment in the control group.The mean values of PaCO₂ before and after treatment were 60.225±15.4709mmHg and 54.406±12.0672mmHg respectively in the observation group and 59.388±13.1601mmHg and57.756±9.9487mmHg before and after treatment in the control group.There was a significant difference in PaO₂,PaCO₂ between the observation group and the control group after treatment?P>0.05?.3 Cat score:the mean values of cat before and after treatment were 26.00±3.862 and17.68±2.765 in the observation group and 26.28±3.747 and 19.76±2.603 in the control group,respectively.There was a significant difference in CAT between the observation group and the control group after treatment?P>0.05?.4 On the 4th day,the mean serum concentration of doxofylline was 7.260±2.7128?g/ml.4 cases of agitated nervous system adverse reactions occurred in the observation group,the incidence rate was 16.The average blood drug concentration in the adverse reaction group was 11.875±1.1266?g/ml.The mean blood drug concentration of no adverse reaction group was 6.6±1.5769?g/ml.There was a significant difference in the concentration of doxophylline between the adverse reaction group and the non-adverse reaction group?P<0.05?.Conclusion1 Doxofylline can improve the clinical symptoms of patients with acute exacerbation of chronic obstructive pulmonary disease.2 Doxofylline could not significantly improve the pH value of patients with acute exacerbation of chronic obstructive pulmonary disease?P>0.05?,but could significantly improve the pao2 and paco2 of patients?P<0.05?.3 Doxofylline significantly improved CAT score in patients with acute exacerbation of chronic obstructive pulmonary disease?P<0.05?.4 The incidence of adverse reactions in clinical use of doxofylline was low,and there was a significant correlation between the incidence of adverse reactions and the serum concentration of doxophylline?P<0.05?.5 Doxofylline can be used safely,stably and without poisoning blood drug concentration,so it can be used in clinic.