噻托溴铵联合奥达特罗对COPD稳定期患者血清炎症因子水平及肺功能的影响
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篇名: 噻托溴铵联合奥达特罗对COPD稳定期患者血清炎症因子水平及肺功能的影响
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摘要: 目的:探讨噻托溴铵联合奥达特罗对慢性阻塞性肺疾病(COPD)稳定期患者血清炎症因子水平及肺功能的影响。方法:选择2015年5月-2016年10月到我科就诊的135例COPD稳定期患者作为研究对象,按随机数字表法将其分为3组,每组45例。患者均予以常规对症治疗,并按需给予硫酸沙丁胺醇雾化吸入溶液雾化吸入治疗。在此基础上,A组患者给予噻托溴铵吸入粉雾剂雾化吸入,每晚睡前1次,每次18 μg ;B组患者给予奥达特罗吸入喷雾剂吸入,每日1次,每次5 μg;C组患者同时给予噻托溴铵吸入粉雾剂和奥达特罗吸入喷雾剂,用法用量同A、B组。3组患者均连续治疗12个月。比较3组患者治疗前及治疗6、12个月时的血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)、IL-10]水平和肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)和呼气峰流速(PEF)]的变化状况;随访12个月,采用COPD评估测试(CAT)量表评价3组患者治疗前后的生活质量,并记录3组患者发生不良反应的情况。结果:治疗前,3组患者上述指标比较,差异均无统计学意义(P>0.05)。治疗6、12个月后,3组患者的TNF-α、IL-8水平均显著低于治疗前,IL-10水平和FEV1、FVC、PEF均显著高于治疗前,且C组患者上述指标均显著优于A、B组同期,差异均有统计学意义(P<0.05);治疗12个月后,3组患者的CAT评分均显著低于治疗前,且C组患者评分均显著低于A、B组,差异均有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05),且均未见严重不良反应。结论:噻托溴铵联合奥达特罗治疗COPD稳定期患者效果确切,不仅能够有效降低血清炎症因子水平,减轻气道炎症反应,还可明显改善患者的肺功能,提高其生活质量,且不增加不良反应。
ABSTRACT: OBJECTIVE: To investigate the effects of tiotropium bromide combined with olodaterol on senum inflammatory factor levels and pulmonary function in patients with chronic obstructive pulmonary disease (COPD) of stable period. METHODS: From May 2015 to Oct. 2016, 135 patients with COPD stable period in our hospital were selected as the research objects, and divided into 3 groups according to random number table, with 45 cases in each group. All groups were given conventional treatment and aerosol inhalation of salbutamol sulfate atomized inhalation solution. On this basis, group A was given aerosol inhalation of Tiotropium bromide powder for inhalation, once a night before bedtime, 18 μg per time. Group B was given inhalation of Olodaterol spray, qd, 5 μg per time. Group C was given  Tiotropium bromide powder for inhalation and Olodaterol spray with same usage and dosage as group A and B. All 3 groups were treatment for 12 months. The changes of serum inflammatory factors (TNF-α, IL-8 and IL-10) and pulmonary function (FEV1, FVC, PEF) were compared among 3 groups before treatment and 6, 12 months after treatment. After 12-month follow-up, the qualities of life in 3 groups were evaluated by CAT scale. The occurrence of ADR was recorded in 3 groups. RESULTS: Before treatment, there was no statistical significance in above indexes among 3 groups (P>0.05). After 6, 12 months of treatment, the levels of TNF-α and IL-8 in 3 groups were significantly lower than before treatment, while IL-10 level, FEV1, FVC and PEF were significantly higher than before treatment; above indexes of group C were significantly better than those of group A and B, with statistical significance (P<0.05). After 12 months of treatment, CAT scores of 3 groups were significantly lower than before treatment, and those of group C were significantly lower than group A and B, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05), without severe ADR. CONCLUSIONS: Tiotropium bromide combined with olodaterol shows definite efficacy for COPD stable period, not only can effectively reduce the level of inflammatory factors and relieve airway inflammatory response, but also can significantly improve the patient’s lung function and quality of life, without increasing ADR.
期刊: 2018年第29卷第14期
作者: 唐黎
AUTHORS: TANG Li
关键字: 慢性阻塞性肺疾病;噻托溴铵;奥达特罗;炎症因子;肺功能
KEYWORDS: Chronic obstructive pulmonary disease; Tiotropium bromide; Olodaterol; Inflammatory factors; Pulmonary function
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