噻托溴铵粉吸入剂联合环磷腺苷葡胺治疗慢性肺源性心脏病急性加重期临床疗效观察  

Clinical therapeutic efficacy of tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate in the treatment of acute exacerbation of chronic pulmonary heart disease

作　　者：余哲[1] 谢旭东[2] 

机构地区：[1]宁波市第二医院呼吸科,浙江省宁波315010 [2]浙江大学医学院附属第一医院心内科

出　　处：《中国医师杂志》2013年第2期150-152,共3页Journal of Chinese Physician

基　　金：国家科学自然基金（30900614）

摘　　要：目的探讨噻托溴铵粉吸入剂联合环磷腺苷葡胺治疗慢性肺源性心脏病急性加重期的疗效。方法将148例急性加重期慢性肺源性心脏病患者分为观察组（n=74）对照组（n=74），前者接受噻托溴铵粉吸人剂联合环磷腺苷葡胺治疗，后者接受环磷腺苷葡胺治疗。结果观察组治疗前一秒用力呼气容积（FEV1）、用力肺活量（FVC）、PaO2、PaCO2、pH与对照组比较差异均无统计学意义[（1．27±0．44）LVS（1．244-0．47）L、（2．49±0．74）LVS（2．43-4-0．77）L、（51．6±6．6）mmHgVS（51．2±6．7）mmHg、（69．1±8．4）mmHgVS（69．5-4-8．7）mmHg、7．27±0．03VS7．26±0．04．P〉0．05]。治疗后观察组FEV1、FVC、PaO2、PaCO2、pH与对照组比较差异均有统计学意义[（1．45±0．39）LVS（1．31±0．41）L、（2．71±0．63）LVS（2．49±0．54）L、（72．8±5．3）mmHgVS（62．5±6．2）mmHg、（47．7±5．7）mmHgVS（56．2±7．2）mmHg、7．34±0．02VS7．314-0．03，t=2．13、2．28、10．86、-12．65、7．16，P〈0．05]。两组治疗前NYHA分级比较差异均无统计学意义（I级为0、11级17．6％、Ⅲ级47．3％、IV级35．1％vsI级为0、1I级18．9％、llI级44．6％、1V级36．5％，P〉0．05）。治疗后观察组患者NYHA分级（I级25．7％、II级44．6％、m级20．3％、1V级9．4％）显著优于对照组（I级20．3％、II级27．0％、llI级36．5％、1V级16．2％，t=2．27，P〈0．05）。结论噻托溴铵粉吸入剂联合环磷腺苷葡胺治疗急性加重期慢性肺源性心脏病患者的疗效确切，可显著改善其心肺功能。Objective To investigate the therapeutic efficacy of tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate in the treatment of acute exacerbation of chronic pulmonary heart disease. Methods A total of 148 cases of acute exacerbation of chronic pulmonary heart disease were divided into observation group （ n = 74） and control group （ n = 74）. The observation group received tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate, while the control group was given meglnmine adenosine cyclophosphate. Results Before treatment, the forced expiratory volume in one second（ FEVI ）, forced vital capacity（ FVC）, arterial oxygen tension（ PaO2 ）, arterial carbon dioxide partial pressure（PaCO2 ） and pH of the observation group were no significant differences[ （1.27 ± 0.44）L vs （1.24 ±0.47）L,（2.49 ±0.74）L vs （2.43_±0.77）L,（51.6 ±6.6）mmHg vs （51.2±6.7） mmHg, （69. 1 ± 8.4） mmHg vs （69. 5 _± 8. 7 ） mmHg,7.27 ± 0. 03 vs 7.26 ± 0. 04, P 〉 0.05 ]. After treatment, The FEV1 , FVC, PaO2, PaCO2 and pH were significant differences between the 2 groups[ （ 1.45 ± 0. 39）L vs （1.31 ±0.41）L,（2. 71 ±0. 63）L vs （2.49 ±0. 54）L, （72. 8 ±5.3） mmHg vs （62.5 ±6.2） mmHg, （47.7 ± 5.7） mmHg vs （56. 2 ± 7.2） mmHg,7.34 _± 0. 02 vs 7. 31 ± 0.03, t = 2. 13,2. 28,10. 86, - 12. 65,7.16, P 〈0.05]. Before treatment, the I ± IV NYHA cardiac functional grading were no significant differences between the 2 groups（0,17.6% ,47. 3% ,35. 1% vs 0,18.9% ,44. 6% ,36. 5%, P 〉0. 05）. After treatment, theI-IV NYHA cardiac functional grading of the observation group were 25.7%, 44. 6%, 20. 3%, 9. 4% respectively, and the NYHA cardiac functional grading of the observation group was signifi- cantly better than that of the control group（20. 3%, 27.0%, 36. 5%, 16. 2%, t =2. 27, P 〈0. 05）. Con clusions The tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate showed good

关 键 词：投药 吸入 东莨菪碱衍生物 治疗应用 支气管扩张药 治疗应用 环AMP 治疗应用 葡甲胺 治疗应用 药物疗法 联合 肺心病 药物疗法 急性病 慢性病 

分 类 号：R541[医药卫生—心血管疾病]