Clinical efficacy of methylprednisolone combined with bronchoalveolar lavage in treatment of elderly patients with bronchiectasis complicated with infection

Hu Kai; Zhao Zhangquan; Li Xiao

doi:10.3969/j.issn.1672-8157.2025.06.006

Abstract：Objective To study the therapeutic effect of methylprednisolone combined with bronchoalveolar lavage on elderly patients with bronchiectasis complicated with infection.Methods Clinical data of 72 elderly patients with bronchiectasis compli-cated with infection who were admitted to the First People's Hospital of Zhumadian from March 2022 to December 2024 were retro-spectively analyzed.According to the treatment methods,the patients were divided into two groups.The control group(36 cases)was treated with conventional therapy combined with bronchoalveolar lavage,and the combined group(36 cases)was treated with meth-ylprednisolone on the basis of the control group.The data of the two groups were compared:clinical efficacy,time to improvement of symptoms including fever,cough and pulmonary rales,changes in inflammatory cytokine levels before and after treatment such as serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT),changes in pulmonary function indica-tors including peak expiratory flow(PEF),forced vital capacity(FVC)and forced expiratory volume in one second(FEV1),as well as the incidence of complications.Results The total effective rate of the combined group was 94.44%(34/36),which was higher than 77.78%(28/36)of the control group(χ²=4.181,P<0.05).The improvement time of fever,cough and pulmonary rales in the com-bined group was(2.45±0.34)d,(3.24±0.29)d and(2.49±0.19)d,respectively,shorter than(3.42±0.23)d,(4.32±0.46)d and(3.36±0.20)d,respectively in the control group(t=14.178,11.917,18.922,all P<0.05).After treatment,the levels of TNF-α,CRP and PCT in the combined group were(22.85±5.12)pg·mL-1,(5.69±0.85)mg·L-1,and(3.18±0.59)ng·mL-1,respectively,which were lower than(31.54±4.92)pg·mL-1,(8.14±0.95)mg·L-1,and(4.59±0.62)ng·mL-1,respectively in the control group(t=7.343,11.532,9.885,all P<0.05).After treatment,the PEF,FVC and FEV1 levels in the combined group were(2.67±0.29)L·s-1,(2.48±0.45)L,and(1.28±0.18)L,respectively,which were higher than(2.33±0.38)L·s-1,(2.13±0.54)L,and(1.18±0.20)L,respectively in the control group(t=4.268,2.988,2.230,all P<0.05).The incidence of complications in the combined group was 2.78%(1/36),lower than 13.89%(5/36)in the control group,but the difference was not statistically significant(χ²=1.636,P>0.05).Conclusion The combined treatment of methylprednisolone and bronchoalveolar lavage has a significant effect on elderly patients with bronchiectasis complicated with infec-tion.It can reduce the inflammatory response of the body,improve the pulmonary function,and promote faster recovery of patients.