噻托溴铵联合沙美特罗替卡松治疗中重度COPD的临床观察
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篇名: 噻托溴铵联合沙美特罗替卡松治疗中重度COPD的临床观察
TITLE:
摘要: 目的:观察噻托溴铵联合沙美特罗替卡松治疗中重度慢性阻塞性肺疾病(COPD)的临床效果。 方法:选取119例中重度COPD患者按照入院顺序分为对照组(54例)和观察组(65例)。对照组患者给予沙美特罗替卡松粉吸入剂50 μg,bid;观察组患者在对照组基础上给予噻托溴铵粉雾剂18 μg,qn。两组患者疗程均为1个月。观察两组患者的第1秒用力呼气量(FEV1)、用力肺活量(FVC)和深吸气量(IC)等肺功能指标,血氧饱和度(SaO2)、二氧化碳分压(PaCO2)和氧分压(PaO2)等血气指标,白细胞介素(IL)-8和肿瘤坏死因子α(TNF-α)等炎症因子水平和COPD评估测试(CAT)评分,并观察不良反应发生情况。结果:治疗前,两组患者上述指标比较,差异均无统计学意义(P>0.05)。治疗后,观察组患者FEV1、FVC和IC等指标均较治疗前明显升高,SaO2和PaO2明显升高,PaCO2、EL-8和TNF-α水平明显降低,且观察组患者上述指标明显优于对照组,差异均有统计学意义(P<0.05);两组患者CAT评分较治疗前均明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:噻托溴铵联合沙美特罗替卡松治疗中重度COPD临床疗效较好,安全性较高。
ABSTRACT: OBJECTIVE: To observe the clinical effect of tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate in the treatment of  medium and severe COPD. METHODS: 119 patients with medium and severe COPD were divided into control group (54 cases) and observation group (65 cases) according to admission order. Control group was treated with Salmeterol xinafoate and fluticasone propionate powder for inhalation 50 μg, bid; observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qn. Both groups received 1 month of treatment. Lung function indexes as FEV1, FVC and IC, blood gas indexes as SaO2, PaCO2 and PaO2 and inflammatory factors as IL-8 and TNF-α, COPD assessment test (CAT) score were observed in 2 groups, and the occurrence of ADR was also observed. RESULTS: Before treatment, there was no statistical significance in above indexes between 2 groups (P>0.05). After treatment, FEV1, EVC, IC of observation group were increased significantly, SaO2 and PaO2 of observation group were increased significantly, while PaCO2, IL-8 and TNF-α levels was decreased significantly; those indexes of observation group were significantly better than  those of control group, with statistical significance (P<0.05).  CAT score of 2 groups were decreased significantly compared to before treatment, and the observation group was significantly lower than control group, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:  Tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate shows good clinical efficacy and safety in the treatment of medium and severe COPD.
期刊: 2016年第27卷第35期
作者: 路宏燕,付臣
AUTHORS: LU Hongyan,FU Chen
关键字: 慢性阻塞性肺疾病;沙美特罗替卡松;噻托溴铵;肺功能;血气指标;炎症因子
KEYWORDS: COPD; Salmeterol xinafoate and fluticasone propionate; Tiotropium bromide; Lung function; Blood gas index; Inflammatory factor
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