The effect of piperacillin tazobactam combined with ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease and its impact on patients'serum soluble CD40 ligand and matrix metalloproteinase 9 levels

Chen Wendeng; Zheng Xiangzhen; Lu Weiwei

doi:10.3760/j.issn.1673-4777.2024.08.008

Abstract：Objective To explore the effect of piperacillin tazobactam combined with ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary(AECOPD)disease and its impact on patients'serum soluble CD40 ligand(sCD40L)and matrix metalloproteinase 9(MMP-9)levels.Methods A total of 95 AECOPD patients admitted to the 909th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from March 2022 to April 2023 were selected.According to the random number table method,patients were divided into observation group(48 cases)and control group(47 cases).The control group received intravenous infusion of piperacillin tazobactam on the basis of routine treatment,while the observation group received intravenous infusion of ammonium bromide hydrochloride combined with piperacillin tazobactam on the basis of routine treatment,both of which were treated continuously for 7 d.The clinical efficacy of the two groups,changes in lung function,blood gas indicators,serum sCD40L and MMP-9 levels before and after treatment,and incidence of adverse reactions after treatment were compared.Results The total effective rate of the observation group was higher than that of the control group[95.8％(46/48)vs 80.9％(38/47)](P＜0.05).After treatment,the lung function indicators forced expiratory volume in the first second(FEV1),FEV,to forced vital capacity ratio,FEV,as a percentage of expected value,and blood gas analysis indicators arterial partial pressure of oxygen and pH in the observation group were significantly higher than those in the control group,while arterial carbon dioxide partial pressure was significantly lower than that in the control group(all P＜0.05).After treat-ment,the average levels of serum sCD40L and MMP-9 in the observation group were significantly lower than those in the control group(all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusions The combination of piperacillin tazobactam and ambr-oxol hydrochloride has a significant therapeutic effect on AECOPD patients.It can improve lung function and blood gas analysis results,reduce serum sCD40L and MMP-9 levels,and its mechanism is related to effective control of inflammatory response and inhibition of airway remodeling.