不同剂量沙美特罗／氟替卡松治疗对稳定期慢性阻塞性肺疾病患者气道炎症和生理学功能的影响  

Effect and its side effects of long-term inhalation of different doses of saimeterol/fluticasone on moderate to severe stable chronic obstructive pulmonary disease patients＇ airway inflammation and physiological function

作　　者：霍晓颖[1] 崔萌[2] 石志红[1] 

机构地区：[1]西安交通大学第一附属医院呼吸科,710061 [2]西安市第四医院呼吸科,710004

出　　处：《国际呼吸杂志》2012年第17期1290-1293,共4页International Journal of Respiration

摘　　要：目的探讨长期吸入不同剂量沙美特罗／氟替卡松对中重度稳定期慢性阻塞性肺疾病（chronicobstructivepulmonarydisease，COPD）患者的气道炎症及生理学功能的影响以及药物的不良反应，通过不同剂量沙美特罗／氟替卡松治疗的对比，从而探索中重度稳定期COPD患者更为合理的安全有效经济的长期治疗方案。方法对89例确诊为稳定期中重度COPD的患者分两组分别给予吸入沙美特罗／氟替卡松50／250μg，每日两吸及沙美特罗／氟替卡松50／500μg，每日两吸。治疗6个月，分别比较治疗前后炎症指标及肺功能指标等的变化以及组间上述指标变化的差异。结果①肺功能指标比较：A组B组在治疗后6个月时FEV1％pred、FEV1／FVC指标的平均值均有升高，且与治疗前比较差异有统计学意义（P〈O．05），组间比较表明，两组FEV1％pred，FEV1／FVC的改善程度相比差异无统计学意义（P〉0．05）。②生活质量评分比较：两组QOL评分治疗后有改善，较治疗前相比差异有统计学意义，组间比较差异无统计学意义。③炎症指标比较：6个月时两组血清CRP值及诱导痰中性粒细胞计数较治疗前相比差异有统计学意义，B组改善优于A组，差异有统计学意义。④不良反应发生率比较，两组差异无统计学意义（P〉0．05）。结论长期吸入不同剂量的沙美特罗／氟替卡松均能够延缓稳定期中重度COPD患者肺功能的恶化，减轻炎症反应，改善生活质量，减少急性发作，吸入高剂量沙美特罗／氟替卡松在减轻炎症反应方面有优势。Objective The aim of this study is to investigate the effect and its side effects of long- term inhalation of different doses of salmeterol/fluticasone on moderate to severe stable chronic obstructive pulmonary disease （COPD） patients＇ airway inflammation and physiological function. By comprising the effect of different dose of salmeterol/fluticasone treatment to explore a more reasonable long-term treatment for the stability of moderate to severe COPD patients. Methods 89 cases diagnosed as stable patients with moderate to severe COPD were divided into Group A and B. Both Group A and B were treated with inhaled sa｜meterol/fluticasone 50/250 μg twice daily or 50/500 μg twice daily, respectively. The treatment lasted for 6 months, inflammatory markers and lung function index and their difference between two groups were compared before and after treatment. Results OComparison of lung function ： after 6 months treatment, both A and B group patients＇ FEV1 % predicted value and FEVI/FVC average value have increased, and the comparison shows statically significant （P 〈 0.05 ）, the comparison between the two groups showed no statistical difference on FEVI % predicted value and FEV1/FVC improvement （ P 〉 0.05）. （2）Quality of life scores： both groups showed improvement on QOL score after treatment comparing with their QOL score before treatment, and its difference is statically significant, the difference between two groups was not significant statically. （3）Comparison of inflammatory markers：both groups＇ serum CRP value and induced sputum cell value showed statistically significant difference after 6 month treatment, B group has better improvement than A group and the difference was statistically significant. （4） Adverse drug reactions, there was no significant difference between the two groups （P 〉 0.05）. Conclusions The long-term inhalation of different doses of salmeterol/fluticasone were able to delay stable moderate to severe COPD patients＇ lung function exacerbati

关 键 词：慢性阻塞性肺疾病 稳定期 沙美特罗 氟替卡松 肺功能 炎症 

分 类 号：R563.9[医药卫生—呼吸系统]